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Treating Recurrent Gliomas with Intense Precision and Hope

June 10, 2021

While there is no cure for gliomas – and they are challenging to manage because they grow within the brain and inevitably reoccur – there are very effective treatments. The current standard of care when a glioma is first diagnosed includes surgery followed by radiation, chemotherapy and tumor treating fields, mild electrical fields that pulse through the skin and interrupt the cancer cells’ ability to divide.

Stereotactic radiosurgery (SRS) is a radiation technique that delivers numerous narrow, precisely aimed, highly focused beams of converging radiation to the designated target. At Overlook Medical Center, the CyberKnife® system of SRS is used to administer this second course of radiotherapy with robotic precision and sub-millimeter accuracy. 

The CyberKnife system noninvasively delivers treatment using a linear accelerator mounted on a robotic arm. High energy X-rays, guided by real-time imaging, are delivered to the tumor, avoiding healthy tissue while reducing and potentially preventing post-treatment-related toxicity. Patients are able to continue their normal activities – as well as their current systemic therapy regimens – while receiving SRS. 

Key to SRS’s success in treating repeat gliomas is choosing the appropriate patient, based on the amount of time that has passed since the initial diagnosis and the first course of therapy, the patient’s overall condition, the extent of the recurrent disease and the anticipated prognosis. 

SRS can not only prolong survival – it can prolong high quality survival. 

In general, most recent retrospective studies have shown that overall survival from the time of reirradiation can range from seven to 16 months, which compares favorably to the overall anticipated survival in patients with recurrent glioma. Oftentimes SRS, in combination with medical treatment for a recurrent glioma, can noninvasively keep the tumor under control. 

“Having a noninvasive alternative is an important benefit to our patients and their families during this critical time,” Joana S. Emmolo, MD, director of radiation oncology at Overlook Medical Center, comments. “Enabling them to enjoy family and social events without disruption while battling this aggressive disease is a blessing.”

Treating recurring gliomas is not as straightforward, but many options exist. 

They can include: 

  • Enrollment in a clinical trial to evaluate novel treatment agents
  • A second surgery when possible for removal of the tumor
  • Repeat radiation if a long period of time has passed since initial treatment
  • Systemic therapies such as targeted drugs that attack the specific genes and proteins involved in the growth and survival of cancer cells
  • Stereotactic radiosurgery (SRS)