Fractionated stereotactic radiosurgery and concurrent taxol in recurrent glioblastoma multiforme: a preliminary report.

Abstract Purpose : Surgery and systemic chemotherapy offer modes benefit to patients with recurrent glioblastoma multiforme. These tumors are associated with rapid growth and progressive neurological deterioration. Radiosurgery offers a rational alternative treatment, delivering intensive local therapy. A pilot protocol to treat recurrent glioblastoma was developed using fractionated stereotactic radiosurgery with concurrent intravenous (i.v.) Taxol as a radiation sensitizer. Methods and Materials : The treatment outcome was analyzed in 14 patients with recurrent glioblastoma treated with fractionated stereotactic rediosurgery and concurrent Taxol. Median tumor volume was 15.7 cc and patients received a mean radiation dose of 6.2 Gy at 90% isosdose line, 4 times weekly. The mean dose of Taxol was 120 mg/m 2 . Results : The mean survival was 14.2 months, 1-year survival was 50%. Conclusions : Survival for this small group of patients was similar to or better than historical controls or patients treated with single-fraction radiosurgery alone. This data should stimulate the investigation of both fractionated radiosurgery and the development of radiation sensitizers to further enhance treatment.