RADT-74. SURGICALLY TARGETED RADIATION THERAPY FOR RECURRENT GRADE IV GLIOMAS: INITIAL RESULTS FROM A MULTICENTER PROSPECTIVE COHORT STUDY

Abstract BACKGROUND Recurrent Grade IV gliomas are difficult to treat, particularly in patients who have already received definitive radiotherapy. Surgically targeted radiation therapy (STaRT) using Cesium-131 (Cs-131) collagen-tile brain brachytherapy (GammaTile®, GT Medical Technologies, Tempe, Arizona, USA), delivers immediate, localized radiation to the surgical cavity at higher doses than conventional adjuvant therapies, potentially improving clinical outcomes. METHODS The prospective observational registry (NCT04427384) is a multicenter study that evaluates clinical outcomes that measures effectiveness and safety of patients receiving brain tumor resection and STaRT. Herein, prospectively collected data from 122 patients with recurrent Grade IV glioma treated at 27 USA institutions were analyzed. Baseline demographic, clinical, and operative data were collected, including isocitrate dehydrogenase (IDH) mutation, O6-methylguanin-DNA methyltransferase (MGMT) promoter methylation status, extent of resection, and treatment-related toxicity. Patients were followed longitudinally to assess survival, recurrence, and toxicity. Kaplan-Meier curves and Cox regression were used for survival analysis. RESULTS The cohort included 71 males and 51 females (median age 61) and preoperative Karnofsky Performance Scale (KPS) of 80, but recovered by one month. Most patients (91.8%) had prior radiotherapy (median dose 60 Gy). Gross total resection was achieved in 66.7% of cases. A 12.2% toxicity rate occurred within 30 days; one patient experienced Grade 4 toxicity, there were no Grade 5 events. Median follow-up was 7.5 months, with overall median survival from STaRT of 13.6 months. IDH-mutant patients had longer survival than IDH wild-type (18.9 versus 13.1 months; p=0.045). MGMT methylation status was not associated with survival differences. Six- and 12-month progression-free survival rates were 74.6% and 56.6%, with local control (LC) at 91.8% and 87.7%, respectively. CONCLUSIONS STaRT was well-tolerated, demonstrating promising survival and LC outcomes, with median survival from STaRT exceeding published operative series. These results support further investigation of STaRT as part of a multimodal strategy for recurrent glioblastoma.

Authors

Institutions

Publication Details

Journal
Neuro-Oncology
Published
2025-11-01
DOI
https://doi.org/10.1093/neuonc/noaf201.0443
Primary Topic
Glioma Diagnosis and Treatment
Type
article
Field-Weighted Citation Impact
0.00
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

RADT-74. SURGICALLY TARGETED RADIATION THERAPY FOR RECURRENT GRADE IV GLIOMAS: INITIAL RESULTS FROM A MULTICENTER PROSPECTIVE COHORT STUDY

Mitesh V. Shah, Linda Chan, Stuart M. C. Lee, Mark Hoeprich et al.
Neuro-Oncology
Glioma Diagnosis and Treatment
article

RADT-74. SURGICALLY TARGETED RADIATION THERAPY FOR RECURRENT GRADE IV GLIOMAS: INITIAL RESULTS FROM A MULTICENTER PROSPECTIVE COHORT STUDY

Mitesh V. Shah, Linda Chan, Stuart M. C. Lee, Mark Hoeprich, Robert J. Ryan, Lindsey Sloan, Ondrej Choutka, Andrea Wasilewski, Kris A. Smith, Parag Sevak, David J. McCracken, Jeffrey S. Beecher, Harish Babu, Vincent DiNapoli, Susan M Woody, Adam Nowlan, Devon H. Haydon, Kushal Shah, Akash Patel, Andrew Ju, Simon Hanft, Clark Chen, Mohamed H. Khattab, M Sean Peach, John E. Wanebo, A. Lavaf, Angela Mae Richardson, Catherine E Mercado, Huong Thi-Thu Pham, Xiaoran Zhang, David G Brachman, Colette Shen, Lewis Z. Leng, Toral Patel, Bryce A Pugh, John Floyd
article en

Abstract

Abstract BACKGROUND Recurrent Grade IV gliomas are difficult to treat, particularly in patients who have already received definitive radiotherapy. Surgically targeted radiation therapy (STaRT) using Cesium-131 (Cs-131) collagen-tile brain brachytherapy (GammaTile®, GT Medical Technologies, Tempe, Arizona, USA), delivers immediate, localized radiation to the surgical cavity at higher doses than conventional adjuvant therapies, potentially improving clinical outcomes. METHODS The prospective observational registry (NCT04427384) is a multicenter study that evaluates clinical outcomes that measures effectiveness and safety of patients receiving brain tumor resection and STaRT. Herein, prospectively collected data from 122 patients with recurrent Grade IV glioma treated at 27 USA institutions were analyzed. Baseline demographic, clinical, and operative data were collected, including isocitrate dehydrogenase (IDH) mutation, O6-methylguanin-DNA methyltransferase (MGMT) promoter methylation status, extent of resection, and treatment-related toxicity. Patients were followed longitudinally to assess survival, recurrence, and toxicity. Kaplan-Meier curves and Cox regression were used for survival analysis. RESULTS The cohort included 71 males and 51 females (median age 61) and preoperative Karnofsky Performance Scale (KPS) of 80, but recovered by one month. Most patients (91.8%) had prior radiotherapy (median dose 60 Gy). Gross total resection was achieved in 66.7% of cases. A 12.2% toxicity rate occurred within 30 days; one patient experienced Grade 4 toxicity, there were no Grade 5 events. Median follow-up was 7.5 months, with overall median survival from STaRT of 13.6 months. IDH-mutant patients had longer survival than IDH wild-type (18.9 versus 13.1 months; p=0.045). MGMT methylation status was not associated with survival differences. Six- and 12-month progression-free survival rates were 74.6% and 56.6%, with local control (LC) at 91.8% and 87.7%, respectively. CONCLUSIONS STaRT was well-tolerated, demonstrating promising survival and LC outcomes, with median survival from STaRT exceeding published operative series. These results support further investigation of STaRT as part of a multimodal strategy for recurrent glioblastoma.

Neuro-OncologyVol. 27(Supplement_5)
University of North Carolina at Chapel Hill (US), University of Minnesota (US), Abbott Northwestern Hospital (US), Westchester Medical Center (US), Orlando Health (US), Georgetown University (US), East Carolina University (US), Norton Healthcare (US), SUNY Upstate Medical University (US), Atlantic University (US), Brown University (US), Franciscan Health (US), Kettering College (US), Piedmont Atlanta Hospital (US), California Pacific Medical Center (US), Tampa General Hospital (US), MedStar Georgetown University Hospital (US), BayCare Health System (US), Tempest Technologies (United States) (US), Desert Regional Medical Center (US), Indiana University Bloomington (US), MemorialCare Health System (US), Mayfield Brain & Spine (US), Pacific Medical (China) (CN), HonorHealth (US), St. Luke's Hospital (US), Eden Medical Center (US), Saint Alphonsus Health System (US), Campbell Collaboration (NO), Medical Technologies (Czechia) (CZ), The University of Texas at San Antonio (US), Seattle University (US), Florida Atlantic University (US), The University of Texas Southwestern Medical Center (US)
Openalex Percentile: Top 51%
Glioma Diagnosis and Treatment
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.