10085-RT-2 TREATMENT RESULTS OF AVAGAMMA THERAPY FOR RECURRENT GLIOBLASTOMA COMBINED WITH GAMMA KNIFE AND BEVACIZUMAB
Kenichi Sato, Taku Asanome, Yuuki Ishida, Ryuunosuke Yoshihara, Hironori Sugio, Masami Takanashi, Hirohiko Nakamura- Surgery
- Oncology
- Neurology (clinical)
Abstract
PURPOSE
We report the treatment results of AVAgamma therapy combining gamma knife (GK) and bevacizumab (Bev) for recurrent glioblastoma.
SUBJECTS
From August 2013 to July 2023, 64 patients with recurrent glioblastoma treated with AVAgamma therapy as salvage therapy at the time of relapse after initial treatment. The average age is 64.2 years, with 38 men and 26 women. The tumor volume is 150 ml or less, and KPS is 40% or more as the indication of AVAgamma therapy. The mean therapeutic borderline dose was 24.2 Gy. Bevacizumab was administered 10 mg / kg or 15 mg / kg 1 to 10 times after GK. [Methods]: Median progression-free survival (mPFS) and median survival (mOS) from AVAgamma treatment, and mOS and 5-year survival rate from initial treatment were compared with historical controls (GK group: 30 patients) who received only GK at the time of recurrence.
RESULTS
The mPFS from AVAgamma therapy was 6 months, PFS-6m was 39%, OS-6m was 76%, and mOS was 10 months. The mOS from initial treatment was 25 months, which was prolonged compared to 21 months in the GK group (p=0.07). The 5-year survival rate for recurrent glioblastoma was 5% in the GK group and 22% in the AVAgamma group (p=0.07). The 5-year survival rate for glioblastoma with KPS greater than 70% at recurrence was 0% in the GK group and 29% in the AVAgamma group (p=0.09).
DISCUSSION
Combined use of Bev with GK was considered to provide local control of recurrent lesions and prolong life prognosis in patients with good KPS at the time of recurrence.
CONCLUSION
AVAgamma therapy is thought to prolong the survival of recurrent glioblastoma and play an important role as salvage treatment.