Zaheen Shibli, Aurangzeb Kalhoro, Kashif Ahmed, Abdul Sattar M Hashim.
PET-CT Guided Gamma Knife Radiosurgery for Recurrent Glioblastoma Multiforme Recurrent Cases in Pakistan.
Pak J Neuro Surg Jan ;27(2):251-8.

Objective: The treatment of recurrent Glioblastoma Multiforme (r-GBM) poses a significant confronts to neurosurgeons. This study was conducted to assess the effectiveness of PET-CT-guided Gamma Knife radiosurgery (GKRS) in treating r-GBM. The purpose of the study is to determine the outcome of this treatment approach. Materials and Methods: Retrospective descriptive research was supervised at the Neurospinal and Cancer Care Institute, Karachi Pakistan between June 2017 to August 2022. The study comprised patients with biopsy-confirmed Grade IV Glioblastoma Multiforme who experienced recurrence during follow-up. PET-CT and MRI brain with contrast were performed to determine the target volume of the tumor, and GKRS was carried out based on the scan findings. Results: A total of 24 patients, ranging in age from 47 to 77 years with a median age of 50 years, were included in the study. The tumor recurrence occurred within a median interval of 10 months after diagnosis, ranging from 1 to 16 months. The median time for progression-free survival from GKRS was 5 months, ranging from 2 to 6 months. The median overall survival from GKRS was 11 months, ranging from 5 to 12 months. Conclusion: GKRS is a tool in the multimodal treatment of r-GBM. By co-registering PET-CT-MRI, it becomes possible to plan the treatment more effectively by targeting the active tumor while preserving healthy brain tissue. This approach has the potential to improve overall survival rates and patient outcomes.

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