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Fractionated stereotactic radiotherapy using gamma unit after hyperbaric oxygenation on recurrent high-grade gliomas

  • CLINICAL-PATIENT STUDIES
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Abstract

Background

To reduce this complication and to enhance the radiation effect to hypoxic cells of high-grade gliomas, the authors performed noninvasive fractionated stereotactic radiotherapy (FSRT) using a Gamma unit combined with hyperbaric oxygen (HBO) therapy for the treatment of recurrent disease.

Patients and methods

Twenty-five consecutive patients who had previously received radiotherapy with chemotherapy for recurrent high-grade gliomas, including 14 patients with anaplastic astrocytoma (AA) and 11 with glioblastoma multiforme (GBM), underwent Gamma FSRT immediately after HBO therapy (2.5 atmospheres absolute for 60 min). The Gamma FSRT was repeatedly performed using a relocatable head cast. Median tumor volume was 8.7 cc (range, 1.7–159.3 cc), and the median total radiation dose was 22 Gy (range, 18–27 Gy) to the tumor margin in 8 fractions.

Results

Actuarial median survival time after FSRT was 19 months for patients with AA and 11 months for patients with GBM, which was significantly different (P = 0.012, log-rank test). Two patients underwent subsequent second FSRT for regional or remote recurrence. Seven patients (28%) underwent subsequent craniotomies and resections at a mean of 8.4 months after FSRT treatment, and 4 of them had radiation effects without viable cells and remained alive for 50–78 months.

Conclusion

Gamma FSRT after HBO therapy appears to confer a survival benefit for patients with recurrent high-grade gliomas and warrants further investigation.

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Authors and Affiliations

  1. Division of Hyperbaric Medicine and Department of Neurosurgery, University Hospital of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, 807-8555, Kitakyushu, Japan

    Kiyotaka Kohshi

  2. Division of Gamma Knife Center, Fukuoka Wajiro Hospital, Fukuoka, Japan

    Haruaki Yamamoto & Masashi Takagi

  3. Department of Public Health, School of Medicine, Miyazaki Universiry, Miyazaki, Japan

    Ai Nakahara & Takahiko Katoh

Authors
  1. Kiyotaka Kohshi
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  2. Haruaki Yamamoto
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  3. Ai Nakahara
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  4. Takahiko Katoh
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  5. Masashi Takagi
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Corresponding author

Correspondence to Kiyotaka Kohshi.

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Kohshi, K., Yamamoto, H., Nakahara, A. et al. Fractionated stereotactic radiotherapy using gamma unit after hyperbaric oxygenation on recurrent high-grade gliomas. J Neurooncol 82, 297–303 (2007). https://doi.org/10.1007/s11060-006-9283-1

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  • DOI: https://doi.org/10.1007/s11060-006-9283-1

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