ArticleJournal of neuro-oncology2025
The impact of the molecular and genetic properties of glioblastoma on patient outcomes following stereotactic radiosurgery at recurrence.
Article in Journal of neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThe role of stereotactic radiosurgery (SRS) in the management of recurrent glioblastoma (rGB) is controversial. Here, we investigate how tumor characteristics impact patient outcomes following SRS.
methodsAn IRB-approved retrospective review of SRS-treated rGB patients was performed. Clinical, histological, molecular, imaging, and radiosurgical data were collected. Overall survival (OS) and progression free survival (PFS) were analyzed using Cox models.
resultsForty-nine rGB patients (83 lesions) were treated; median age was 61 years (range: 21–78), median post-SRS follow-up was 9.2 months (range: 2.8–77.3). Median tumor volume and diameter at SRS were 2.0 cm3 and 1.4 cm, respectively. Median prescription dose was 24 Gy. Post-SRS, median OS and PFS was 10.7 (95% CI 8.3–13.0) and 3.8 months (95% CI 2.8–5.6), respectively. Multivariate analysis demonstrated improved OS with tumor volume ≤ 2 cm3 (p = 0.006), > 8 months from diagnosis to recurrence (p = 0.0003), and no loss of heterozygosity in tumor-suppressor rich chromosome 19q13 (p = 0.001). Median OS for patients with and without ≥ 2 of these features was 15.1 (95% CI 11.5–39.5) and 7.56 months (95% CI 5.3–11.8), respectively. Improved PFS was associated with Ki-67 index > 50% (p = 0.003), p53 staining ≥ 30% (p = 0.03), and > 8 months between diagnosis and recurrence (p = 0.05). Median PFS for patients with and without ≥ 2 of these features was 6.7 (95% CI 4.6–9.4) and 2.8 months (95% CI 2.3–4.1), respectively.
conclusionsSRS may be especially promising for rGB patients with favorable prognostic features, as patients with ≥ 2 of the identified favorable OS/PFS prognostic features experienced a 2x and 2.4x increase in OS/PFS, respectively.
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