Abstract

Clinical case: 30-year-old female patient with Glioblastoma multiforme (GBM) IDH (-) MGMT (-) TERT mut, 1p19q, referred in 2018 to the radio oncology service of the National Cancer Institute of Santiago de Chile to complement treatment after surgery macroscopically complete, under the standard schedule of radio-chemotherapy [1]. During the clinical and imaging follow-up after the primary treatment, two recurrences were evidenced in the left parietal occipital region. This evolution is expected in a tumor that tends to recur in 75 to 80% of cases during follow-up, associated with a poor prognosis. Our patient is treated with systemic therapy, vigilant surgery, and fractionated stereotactic radiosurgery (F-SRS) with excellent tolerance and satisfactory evolution.

Conclusion: This case shows the benefit of multidisciplinary treatments for tumors with high aggressiveness, unfavorable prognosis and that tend to recur like GBM. The evaluation of prognostic factors such as age, Karnofsky (KPS), type of surgery and molecular profile help us to offer additional treatments that prolong global survival and improve quality of life in the event of recurrence, which includes irradiation with fractionated stereotactic radiosurgery. AS a valid rescue option in patients with recurrent or residual malignant gliomas

Keywords: Brain tumors; Glioma; Fractionated stereotactic radiosurgery; Metilación Delpromotor De MGMT;Neuroimaging;Temozolomide

Abbreviations: OMS: Organization Mundial De la Salud; MGMT: Metilación Del Promotor De MGMT; GBM: Glioblastoma Multiforme; VMAT: Arcoterapia Volumétrica Modulada Temozolomide; MRI: Magnetic Resonance Imaging;KPS: Karnofsky; ECOG: Eastern Cooperative Oncology Group