CLIN-MEDICAL + RADIATION THERAPIES

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BACKGROUND: Primary gliosarocoma (GSM) is a rare central nervous system tumor with limited experience reported in the literature.The author presents clinical experience and outcome for primary GSM patients in one medical center.METHOD: Patients with primary GSM were selected using a retrospective review (1990 2011).A meticulous chart review was performed and clinical, pathologic data were taken into analysis.RESULTS: Eleven patients were diagnosed with primary GSM.It was 1.6% that of glioblastoma in the same period.The overall median survival was 12 months.Patients who underwent maximal safe resection were found to have a prolonged median survival compared with patients who only underwent biopsy of the tumor (12 vs 6 months, p ¼ 0.288).All patients received adjuvant postoperative radiotherapy and 7 of 11 patients received chemotherapy with temozolomide.Four patients received gamma-knife radiosurgery for local recurrence.However, gamma-knife radiosurgery did not affect the survival.Patients who received re-explorative surgery for resectable recurred tumor had a prolonged median survival compared to patients who non-resectable recurred tumor (14 vs 6 months, p ¼ 0.0082).CONCLUSION: Primary GSM, like glioblastoma, is a highly malignant tumor of the central nervous system.However, due to its rarity, our experience is limited.According to the guidance for glioblastoma treatment, the standard treatment for primary GSM is maximal safe resection, postoperative radiotherapy, and chemotherapy with temozolomide.Despite an aggressive treatment, the life expectancy of patients diagnosed with GSM is very short.Still, standard treatment is not well established on primary GSM.Accordingly, we need a larger and comprehensive clinical investigation in the future.

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