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Phase
II study of high central dose Gamma Knife radiosurgery and marimastat in
patients with recurrent malignant glioma
Larson DA, Prados M, Lamborn KR, Smith V, Sneed PK, Chang S, Nicholas KM,
Wara WM, Devriendt D, Kunwar S, Berger M, McDermott MW
Department of Radiation Oncology, University of California, San Francisco,
School of Medicine, San Francisco, CA, USA
Purpose. To assess the outcome of high central dose Gamma Knife radiosurgery
plus marimastat in patients with recurrent malignant glioma.
Methods and
Materials. Twenty-six patients with recurrent malignant glioma were enrolled in
a prospective Phase II study between November 1996 and January 1999.
The
radiosurgery dose was prescribed at the 25-30% isodose surface to increase the
dose substantially within the tumor's presumably hypoxic core.
Marimastat was
administered after radiosurgery to restrict regional tumor progression.
Survival
was compared with that of historical patients treated at our institution with
standard radiosurgery.
Results. The median times to progression after
radiosurgery for Grade 3 and 4 patients was 31 and 15 weeks, respectively.
The
corresponding median survival time after radiosurgery was 68 and 38 weeks.
The
median survival time after radiosurgery in the historical patients was 59 and 44
weeks.
Conclusion. The dual strategies of using high central dose radiosurgery to
overcome tumor hypoxia together with marimastat to inhibit local tumor invasion
may offer a small survival advantage for recurrent Grade 3 tumors; they do not
offer an advantage for recurrent Grade 4 tumors.
PMID: 12459362 [PubMed - in process]
Source:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12459362&dopt=Abstract |
