ИСТИНА

Objective: Patients with glioblastoma multiforme (GBM) have a poor prognosis with high recurrence rates. Gamma Knife Stereotactic radiosurgery. Methods: Between 2005 and 2015 in Moscow Gamma Knife Center 98 patients treated with GKRS for recurrent GBM. There are follow up data of only 47 patients. All patients were treated with prior surgery, radiation therapy and chemotherapy. The median time from initial radiation therapy GKRS was 15.5 m. Recurrent disease was treated with GKRS with a median dose 18.0 Gy (range, 10-25 Gy). There are 88 lesions with median of tumor volume was 3.4 сm3 (range, 0.01 - 33.0 сm3). Most of the patients (33) patients had the anti-angiogenic drug therapy (bevacizumab) prior GKRS. Results: The median of progression-free survival (PFS) was 9.2 months. Actuarial progression-free survival was 40,4% at 1 year. The 12-months overall survival (OS) from GKRS was 63.6%, 2 year - 43.2%; 3 year - 36.8%, respectively. Concerning toxicity, there was 2 (4.2%) grade 4 adverse events within this patient series. Group patients (33 pts) with bevacizumab had no any statistical differences (p=0.2) in PFS and OS with patients how had no targets prior GKRS. Median PFS was 9.0 m and 10.5 m, median OS was 19.8 m and 16.9 m, respectively. Conclusions: Our outcomes suggest that GKRS with bevacizumab is a feasible treatment option with acceptable salvage survival rate for patients with glioblastoma. It is necessary to investigate the question of the timing of the appointment of bevacizumab and radiosurgery and in what order they should be administered.