AuthorsLehrer, E. J.
Nehlsen, A. D.
Sindhu, K. K.
Estrada, R. S.
Borst, G. R.
Sheehan, J. P.
Trifiletti, D. M.
AffiliationDepartment of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA. Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL 32224, USA. Department of Neurological Surgery, Mayo Clinic, Jacksonville, FL 32224, USA. The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK. Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, 555 Wilmslow Road, Manchester M20 4GJ, UK. Department of Neurological Surgery, University of Virginia, Charlottesville, VA 22908, USA.
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AbstractGlioblastoma is a devastating primary brain tumor with a median overall survival of approximately 15 months despite the use of optimal modern therapy. While GBM has been studied for decades, modern therapies have allowed for a reduction in treatment-related toxicities, while the prognosis has largely been unchanged. Adjuvant stereotactic radiosurgery (SRS) was previously studied in GBM; however, the results were disappointing. SRS is a highly conformal radiation technique that permits the delivery of high doses of ionizing radiation in 1–5 sessions while largely sparing surrounding healthy tissues. Furthermore, studies have shown that the delivery of ablative doses of ionizing radiation within the central nervous system is associated with enhanced anti-tumor immunity. While SRS is commonly used in the definitive and adjuvant settings for other CNS malignancies, its role in the preoperative setting has become a topic of great interest due to the potential for reduced treatment volumes due to the treatment of an intact tumor, and a lower risk of nodular leptomeningeal disease and radiation necrosis. While early reports of SRS in the adjuvant setting for glioblastoma were disappointing, its role in the preoperative setting and its impact on the anti-tumor adaptive immune response is largely unknown. In this review, we provide an overview of GBM, discuss the potential role of preoperative SRS, and discuss the possible immunogenic effects of this therapy.
CitationLehrer EJ, Ruiz-Garcia H, Nehlsen AD, Sindhu KK, Estrada RS, Borst GR, et al. Preoperative Stereotactic Radiosurgery for Glioblastoma [Internet]. Vol. 11, Biology. MDPI AG; 2022. p. 194.
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