Radiotherapy after subtotally resected or recurrent ganglioglioma.

Abstract

PURPOSE:

Gangliogliomas can recur after subtotal resection (STR). The role of postoperative radiation therapy (RT) is undefined.

METHODS AND MATERIALS:

Eight consecutive patients with low-grade gangliogliomas (n = 7) or anaplastic gangliogliomas (n = 1) were treated with RT between 1987 and 2004. Median age was 17 years. Five patients received adjuvant RT after STR at a median time of 6 weeks after surgery. Three patients received salvage RT at a median time of 17 months after surgery. The median dose of RT was 54 Gy. Control was defined as no progressive disease on serial imaging. Median follow-up was 8.8 years.

RESULTS:

Of the 7 patients with low-grade gangliogliomas, 3 were controlled after RT and 4 recurred locally. Recurrences were controlled with further surgery (n = 2), chemotherapy (n = 1), or re-irradiation (n = 1) (median follow-up, 9 years after salvage therapy). Patients who received adjuvant RT after STR of their low-grade gangliogliomas had an overall local control rate of 75%. All 3 patients who were treated with salvage RT had recurrences in the treated area alone (n = 2) or in the treated area with leptomeningeal spread (n = 1). The patient with an anaplastic ganglioglioma was treated with adjuvant RT, and had recurrence in the radiation field after 4 months, then died 1 month later.

CONCLUSIONS:

Adjuvant RT may be indicated to treat select patients with subtotally resected gangliogliomas. Salvage RT for recurrence is probably less effective for long-term control; however, patients who recur may still be candidates for effective salvage therapies in the absence of malignant transformation.

• Authors: Stanley L Liauw, Jennifer E Byer, Anthony T Yachnis, Robert J Amdur, William M Mendenhall
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 67 Issue 1 Pg. 244-7 (Jan 01 2007) ISSN: 0360-3016 [Print] United States
• PMID: 17045420 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Brain Neoplasms (radiotherapy, surgery)
• Child
• Child, Preschool
• Combined Modality Therapy (methods)
• Female
• Ganglioglioma (radiotherapy, surgery)
• Humans
• Male
• Neoplasm Recurrence, Local (radiotherapy)
• Neoplasm, Residual
• Radiotherapy Dosage
• Radiotherapy, Adjuvant
• Salvage Therapy