Interstitial brachytherapy procedures for brain tumors

✍ Scribed by Penny K. Sneed; Michael W. McDermott; Philip H. Gutin

• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: English
• Weight: 320 KB
• Volume: 13
• Category: Article
• ISSN: 8756-0437
• DOI: 10.1002/(sici)1098-2388(199705/06)13:3<157::aid-ssu2>3.0.co;2-6

✦ Synopsis

Promising results have been obtained using brachytherapy in the treatment of brain tumors. Very low-dose rate brachytherapy (60-100 Gy given at 0.05-0.10 Gy/h) has been used for low-grade gliomas, resulting in 5- and 10-year survival probabilities of 85% and 83% for pilocytic astrocytomas and 61% and 51% for grade II astrocytomas. Only 2.6% of patients had symptomatic radiation necrosis. For faster-growing high-grade gliomas, temporary implants delivering about 60 Gy at 0.40-0.60 Gy/h are generally used. The largest series have reported median survival times of 12-13 months after brachytherapy for recurrent malignant gliomas and 18-19 months after diagnosis of primary glioblastomas treated with external beam radiotherapy and brachytherapy boost. A recent prospective, randomized trial demonstrated significantly improved survival for high-grade glioma patients who had brachytherapy boost. However, over 50% of patients who undergo brachytherapy for malignant gliomas require reoperation for tumor progression and/or radiation necrosis. Strategies are under development to improve local control without increasing radiation toxicity.