Management of recurrent XXXX .

@entity1 @entity632 @entity5 @entity693 @entity3
BACKGROUND: @entity693 is an uncommon @entity5 with a high propensity for recurrence. The purpose of this study was to analyze the efficacy of different treatment options in @entity1 with recurrent disease. METHODS: The records of all @entity1 with recurrent @entity693 treated at the study institution between 1976 and 1996 were reviewed. RESULTS: Thirty-four consecutive @entity1 were studied. The mainstay of treatment was brain surgery in 21 @entity1 (62%); the median time to recurrence from surgery was 12 months. Ten @entity1 (29%) had 20 recurrent central nervous system (CNS) lesions treated by stereotactic radiosurgery. Of these, 3 previously nonirradiated @entity1 (all with lesion size < 25 mm) achieved a complete response, which persisted at a median of 3 years. In 14 lesions (70%) a partial response (PR) occurred with a median duration of 12 months, whereas 3 lesions (15%) remained stable. Two @entity1 with inoperable CNS lesions received external beam radiation therapy and both had PRs lasting 14 and 24 months, respectively. Nine @entity1 (26%) received radiation therapy for @entity3 . Of these, seven @entity1 remained stable with good symptomatic relief, and two @entity1 experienced @entity5 progression. Chemotherapy with @entity632 -containing regimens was administered in 7 @entity1 (21%); there was only 1 PR that lasted 8 months. The median survival from first recurrence was 4.6 years. CONCLUSIONS: Surgical management is important for the successful treatment of @entity1 with recurrent @entity693 . Radiosurgery plays a definite role in the treatment of smaller recurrent CNS lesions. Radiation therapy is helpful in the management of inoperable @entity5 . More effective chemotherapeutic agents are needed.
