Interventional magnetic-resonance-guided cryotherapy combined with microsurgery for recurrent glioblastoma: An innovative treatment?


Journal

Neuro-Chirurgie
ISSN: 1773-0619
Titre abrégé: Neurochirurgie
Pays: France
ID NLM: 0401057

Informations de publication

Date de publication:
Apr 2022
Historique:
received: 26 07 2021
revised: 27 10 2021
accepted: 19 11 2021
pubmed: 16 12 2021
medline: 6 5 2022
entrez: 15 12 2021
Statut: ppublish

Résumé

Glioblastoma invariably recurs after primary Stupp tumor therapy and portends a poor prognosis. Cryoablation is a well-established treatment strategy for extra-cranial tumors. The safety and efficacy of interventional MR-guided cryoablation (iMRgC) has not been explored in recurrent glioblastoma. A retrospective analysis of data collected over a period of 24 months was performed. The inclusion criteria were: (I) recurrent glioblastoma despite Stupp protocol; (II) MRI followed by histological confirmation of recurrent glioblastoma; (III) location allowing iMRgC followed by microsurgical resection; and (IV) patient's consent. The primary objective was to assess feasibility in terms of complications. The secondary objective was to analyze progression-free survival (PFS), post-iMRgC survival and overall survival (OS). The study included 6 patients, with a mean age of 67±7.6 years [range, 54-70 years]. No major complications were observed. Median PFS was 7.5 months [IQR 3.75-9.75] and 6-month PFS was 50%. Median post-iMRgC survival was 9 months [IQR 7.5-15.25] and 6-month post-iMRgC survival was 80%. Median OS was 22.5 months [IQR 21.75-30]. iMRgC for recurrent glioblastoma demonstrated a good safety profile, with no major complications. Our data suggest improved PFS and OS. No. IRB00011687 retrospectively registred on July 7th 2021.

Sections du résumé

BACKGROUND BACKGROUND
Glioblastoma invariably recurs after primary Stupp tumor therapy and portends a poor prognosis. Cryoablation is a well-established treatment strategy for extra-cranial tumors. The safety and efficacy of interventional MR-guided cryoablation (iMRgC) has not been explored in recurrent glioblastoma.
METHODS METHODS
A retrospective analysis of data collected over a period of 24 months was performed. The inclusion criteria were: (I) recurrent glioblastoma despite Stupp protocol; (II) MRI followed by histological confirmation of recurrent glioblastoma; (III) location allowing iMRgC followed by microsurgical resection; and (IV) patient's consent. The primary objective was to assess feasibility in terms of complications. The secondary objective was to analyze progression-free survival (PFS), post-iMRgC survival and overall survival (OS).
RESULTS RESULTS
The study included 6 patients, with a mean age of 67±7.6 years [range, 54-70 years]. No major complications were observed. Median PFS was 7.5 months [IQR 3.75-9.75] and 6-month PFS was 50%. Median post-iMRgC survival was 9 months [IQR 7.5-15.25] and 6-month post-iMRgC survival was 80%. Median OS was 22.5 months [IQR 21.75-30].
CONCLUSION CONCLUSIONS
iMRgC for recurrent glioblastoma demonstrated a good safety profile, with no major complications. Our data suggest improved PFS and OS.
TRIAL REGISTRATION NUMBER BACKGROUND
No. IRB00011687 retrospectively registred on July 7th 2021.

Identifiants

pubmed: 34906554
pii: S0028-3770(21)00241-1
doi: 10.1016/j.neuchi.2021.11.004
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

267-272

Informations de copyright

Copyright © 2021 Elsevier Masson SAS. All rights reserved.

Auteurs

H Cebula (H)

Department of Neurosurgery, University Hospital of Strasbourg, Strasbourg, France. Electronic address: helene.cebula@hotmail.fr.

J Garnon (J)

Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France.

J Todeschi (J)

Department of Neurosurgery, University Hospital of Strasbourg, Strasbourg, France.

G Noel (G)

Department of Radiation Therapy, ICANS, Strasbourg, France.

B Lhermitte (B)

Department of Histology, University Hospital of Strasbourg, Strasbourg, France.

C-H Mallereau (CH)

Department of Neurosurgery, University Hospital of Strasbourg, Strasbourg, France.

S Chibbaro (S)

Department of Neurosurgery, University Hospital of Strasbourg, Strasbourg, France.

H Burckel (H)

Department of Medical Oncology, ICANS, Strasbourg, France.

R Schott (R)

Department of Medical Oncology, ICANS, Strasbourg, France.

M de Mathelin (M)

Icube-UMR 7357 Télécom Physique, Strasbourg, France.

A Gangi (A)

Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France.

F Proust (F)

Department of Neurosurgery, University Hospital of Strasbourg, Strasbourg, France.

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