Skip to main content

Central Nervous System Tumors

  • Chapter
  • First Online:
Intraoperative Irradiation

Abstract

A heterogenous type of primary tumors arises in the central nervous system (CNS). Considering the natural history of the malignant pathologies, both low- and high-grade tumors show a similar ­behavior with an infiltrating pattern and a high incidence of local recurrence [1].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Shaw EG. Central nervous system tumor: overview. In: Gunderson LL, Tepper JE, editors. Clinical radiation oncology. 2nd ed. Philadelphia: Churchill Livingstone; 2007. p. 457–91.

    Google Scholar 

  2. Leibel SA, Scott CB, Loeffler JS. Contemporary approaches to the treatment of malignant gliomas with radiation therapy. Semin Oncol. 1994;21:198–219.

    PubMed  CAS  Google Scholar 

  3. Curran Jr WJ, Scott CB, Horton J, et al. Recursive partitioning analysis of prognostic factors in three Radiation Therapy Oncology Group malignant glioma trials. J Natl Cancer Inst. 1993;85:704–10.

    Article  PubMed  Google Scholar 

  4. Nelson DF, Diener-West M, Horton J, Chang Ch, Schoenfeld D, Nelson JS. Combined modality approach to treatment of malignant gliomas. Re-evaluation of RTOG 7401/ECOG 1347 with long-term follow-up: a joint Radiation Therapy Oncology Group and Eastern Cooperative Oncology Group Study. Natl Cancer Inst Monogr. 1988;6:279–84.

    Google Scholar 

  5. Wallner KE, Galicich JH, Krol G, Arbit E, Malkin MG. Patterns of failure following treatment for glioblastoma multiforme and anaplastic astrocytoma. Int J Radiat Oncol Biol Phys. 1989;16:1405–9.

    Article  PubMed  CAS  Google Scholar 

  6. Walker MD, Strike TA, Sheline GE. An analysis of dose-effective relationship in the radiotherapy of malignant gliomas. Int J Radiat Oncol Biol Phys. 1979;5:1725–31.

    PubMed  CAS  Google Scholar 

  7. Marks JE, Baglan RJ, Prassad SC, Blank WF. Cerebral radionecrosis: incidence and risk in relation to dose, time, fractionation and volume. Int J Radiat Oncol Biol Phys. 1981;7:243–52.

    Article  PubMed  CAS  Google Scholar 

  8. Stupp R, Mason WP, van den Bent MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma multiforme. N Engl J Med. 2005;352:987–96.

    Article  PubMed  CAS  Google Scholar 

  9. Ortiz de Urbina D, Willich N, Dobelbower RR, Aristu J, Bustos JC, Carter D, et al. IORT for CNS tumors. In: Gunderson LL, Willet CG, Harrison LB, Calvo FA, editors. Intraoperative irradiation. Techniques and results. New Jersey: Humana; 1999. p. 499–520.

    Google Scholar 

  10. Abe M, Fukuda M, Yamamo K, Matsuda S, Handa H. Intraoperative irradiation in abdominal and cerebral tumors. Acta Radiol. 1971;10:408–16.

    Article  CAS  Google Scholar 

  11. Calvo FA, Abuchaibe O, Vanaclocha V, Aguilera F. Intracranial tumors. In: Calvo FA, Santos M, Brady LW, editors. Intraoperative radiotherapy: clinical experiences and results. Heidelberg: Springer; 1992. p. 31–6.

    Google Scholar 

  12. Yanagawa S, Doi H, Sakai N, Yamada H. Intraoperative radiation therapy (IORT) of malignant gliomas. Strahlenther Onkol. 1981;65:781.

    Google Scholar 

  13. Sakai N, Yamada H, Andoh T, et al. Intraoperative radiation therapy for malignant glioma. Neurol Med Chir (Tokyo). 1991;31:702–7.

    Article  CAS  Google Scholar 

  14. Matsutani M, Nakamura O, Nagashima T, et al. Intraoperative radiation therapy for malignant brain tumors: rationale, method and treatment results of cerebral glioblastomas. Acta Neurochir (Wien). 1994;131:80–90.

    Article  CAS  Google Scholar 

  15. Willich N, Palkovic S, Prott FJ, Molgenroth C, Heidgert S, Wassmann H. IORT for malignant brain tumors. In: Vaeth JM, editor. Intraoperative radiation therapy in the treatment of cancer, Frontiers of radiation therapy and oncology. Basel: Karger; 1997. p. 31–96.

    Google Scholar 

  16. Ortiz de Urbina D, Santos M, Garcia-Berrocal I, et al. Intraoperative radiation therapy in malignant glioma: early clinical results. Neurol Res. 1995;17:289–94.

    PubMed  CAS  Google Scholar 

  17. Bucci MK, Maity A, Janss AJ, et al. Near complete surgical resection predicts a favorable outcome in pediatric patients with nonbrainstem, malignant gliomas: results from a single center in the magnetic resonance imaging era. Cancer. 2004;101:817–24.

    Article  PubMed  Google Scholar 

  18. Sanai N, Berger MS. Glioma extent of resection and its impact on patient outcome. Neurosurgery. 2008;62:753–64.

    Article  PubMed  Google Scholar 

  19. Muragaki Y, Iseki H, Maruyama T, et al. Usefulness of intraoperative magnetic resonance imaging for glioma surgery. Acta Neurochir Suppl. 2006;98:67–75.

    Article  PubMed  CAS  Google Scholar 

  20. Sanai N, Mirzadeh Z, Berger MS. Functional outcome after language mapping for glioma resection. N Engl J Med. 2008;358:18–27.

    Article  PubMed  CAS  Google Scholar 

  21. Bleehen NM, Stenning SP. A Medical Research Council trial of two radiotherapy doses in the treatment of grades 3 and 4 astrocytoma. Br J Cancer. 1991;64:769–74.

    Article  PubMed  CAS  Google Scholar 

  22. Walker MD, Green SB, Byar DP, et al. Randomized comparisons of radiotherapy and nitrosoureas for the treatment of malignant glioma after surgery. N Engl J Med. 1990;303:1323–9.

    Article  Google Scholar 

  23. Werner-Wasik M, Scott CB, Nelson DF, et al. Final report of a Phase I/II trial of hyperfractionated and accelerated hyperfractionated radiation therapy with carmustine for adults with supratentorial malignant gliomas: Radiation Therapy Oncology Group Study 83-02. Cancer. 1996;77:1535–43.

    Article  PubMed  CAS  Google Scholar 

  24. Cardinale R, Won M, Choucair A, et al. Phase II of accelerated radiotherapy using weekly stereotactic conformal boost for supratentorial glioblastoma multiforme: RTOG 0023. Int J Radiat Oncol Biol Phys. 2006;65:1422–8.

    Article  PubMed  Google Scholar 

  25. Baumert BG, Lutterbach J, Bernays R, et al. Fractionated stereotactic radiotherapy boost after post-operative radiotherapy in patients with high-grade gliomas. Radiother Oncol. 2003;67:183–90.

    Article  PubMed  Google Scholar 

  26. Chang JL, Lee SW, Fraass BA, et al. Survival and failure patterns of high-grade gliomas after three-dimensional conformal radiotherapy. J Clin Oncol. 2002;2:1635–42.

    Article  Google Scholar 

  27. Tanaka M, Ino Y, Nakagawa K, et al. High-dose conformal radiotherapy for supratentorial malignant glioma: a historical comparison. Lancet Oncol. 2005;6:953–60.

    Article  PubMed  Google Scholar 

  28. Souhami L, Seiferheld W, Brachman D, et al. Randomized comparison of stereotactic radiosurgery followed by conventional radiotherapy with carmustine for patients with glioblastoma multiforme: Report of Radiation Therapy Oncology Group 93 – 05 protocol. Int Radiat Oncol Biol Phys. 2004;60:853–60.

    Article  Google Scholar 

  29. Tsao MN, Mehta M, Whelan T, et al. The American Society for Therapeutic Radiology and Oncology (ASTRO) evidence-based review of the role of radiosurgery for malignant glioma. Int J Radiat Oncol Biol Phys. 2005;63:47–55.

    Article  PubMed  Google Scholar 

  30. Laperriere NJ, Leung PMK, McKenzie S, et al. Randomized study of brachytherapy in the inicial management of patients with malignant astrocytoma. Int J Radiat Oncol Biol Phys. 1998;41:1005–11.

    Article  PubMed  CAS  Google Scholar 

  31. Selker RG, Shapiro WR, Burger P, et al. The Brain Tumor Cooperative Group NIH Trial 87 – 01: a randomized comparison of surgery, external radiotherapy, and carmustine versus surgery, interstitial radiotherapy boost, external radiation therapy, and carmustine. Neurosurgery. 2002;51:343–55.

    Article  PubMed  Google Scholar 

  32. Lee SW, Fraass BA, Marsh LH, et al. Patterns of failure following high-dose 3-D conformal radiotherapy for high-grade astrocytomas: a quantitative dosimetric study. Int J Radiat Oncol Biol Phys. 1999;43:79–88.

    Article  PubMed  CAS  Google Scholar 

  33. Chang EL, Akyurek S, Avalos T, et al. Evaluation of peritumoral edema in the delineation of radiotherapy clinical target volumes for glioblastoma. Int J Radiat Oncol Biol Phys. 2007;68:144–50.

    Article  PubMed  Google Scholar 

  34. Dyke CG, Davidoff KM. Roentgen treatment of disease of the nervous system. Philadelphia: Lea and Febiger; 1942. p. 111–2.

    Google Scholar 

  35. Goldson AL, Streeter Jr OE, Ashayeri E, Collier-Manning J, Barber JB, Fan KJ. Intraoperative radiotherapy for intracranial malignancies. A pilot study. Cancer. 1984;54:2807–13.

    Article  PubMed  CAS  Google Scholar 

  36. Nemoto K, Ogawa Y, Matsushita H, Takeda K, Takai Y, Yamada S, et al. Intraoperative radiation therapy ( IORT ) for previously untreated malignant gliomas. BMC Cancer. 2002;2:1–5.

    Article  PubMed  Google Scholar 

  37. Shibamoto Y, Yamashita J, Takahashi M, Abe M. Intraoperative radiation therapy for brain tumors with emphasis on retreatment for recurrence following full-dose external beam irradiation. Am J Clin Oncol. 1994;17:396–9.

    Article  PubMed  CAS  Google Scholar 

  38. Gouda JJ, Brown JA, Carter D, Dobelbawer RR. Malignant brain tumors treated with IORT. In: Vaeth JM, editor. Intraoperative radiation therapy in the treatment of cancer, Frontiers of radiation therapy and oncology, vol. 31. Basel: Karger; 1997. p. 87–91.

    Chapter  Google Scholar 

  39. Schueller P, Micke O, Palkovic S, et al. 12 years’ experience with intraoperative radiotherapy (IORT) of malignant gliomas. Strahlenther Onkol. 2005;181:500–6.

    Article  PubMed  Google Scholar 

  40. Prott FJ, Willich N, Palkovic S, Horsch C, Wassmann H. A new method for treatment planning and quality control in IORT of brain tumors. In: Vaeth JM, editor. Intraoperative radiation therapy in the treatment of cancer, Frontiers of radiation therapy and oncology, vol. 31. Basel: Karger; 1997. p. 97–101.

    Chapter  Google Scholar 

  41. Rübe Ch, Schüller P, Palkovic S, Wagner W, Prott FJ, Willich N. Intraoperative radiotherapy in brain tumors, Frontiers of radiation therapy and oncology, vol. 33. Basel: Karger; 1999. p. 94–9.

    Google Scholar 

  42. Matsuda T. Intraoperative radiotherapy and confirmation of radiotherapy with special emphasis on the treatment of pancreatic cancer and glioblastoma (Abstr). 4th Asian-Oceanian Congress of Radiology. 1983; 452–453.

    Google Scholar 

  43. Fujiwara T, Homma Y, Ogawa T, Irie K, et al. Intraoperative radiotherapy for gliomas. J Neurooncol. 1995;23:81–6.

    Article  PubMed  CAS  Google Scholar 

  44. Takakura K, Kubo O. Treatment of malignant brain tumors. Gan To Kagaku Ryoho. 2000;27 Suppl 2:449–53.

    PubMed  Google Scholar 

  45. Curry WT, Cosgrove GR, Hochberg FH, Loeffler J, Zervas T. Stereotactic interstitial radiosurgery for cerebral metastases. J Neurosurg. 2005;103:630–5.

    Article  PubMed  Google Scholar 

  46. Kalapurakal JA, Goldman S, Stellpflug W, Curran J, Sathiaseelan Y, Marymont H, et al. Phase I study of intraoperative radiotherapy with photon radiosurgery system in children with recurrent brain tumors: preliminary report of first dose level (10 Gy). Int J Radiat Oncol Biol Phys. 2006;65:800–8.

    Article  PubMed  Google Scholar 

  47. Schueller P, Palkovic S, Moustakis C, Kónemann S, Wassmann H, Willich N. Clinical results and isodose planning of neuronavigation-guided intraoperative radiotherapy (IORT) in 77 brain tumor patients: adequate target volume coverage improve results. Rev Cancer (Madrid). 2008;22(extra):1–58.

    Google Scholar 

  48. Sneed PK, Gutin PH, Larson DA, et al. Patterns of recurrence of glioblastoma multiforme after external irradiation followed by implant boost. Int J Radiat Oncol Biol Phys. 1994;29:719–27.

    Article  PubMed  CAS  Google Scholar 

  49. Halligan JB, Stelzer KJ, Rostomily RC, Spence AM, Griffin TW, Berger MS. Operation and permanent low activity 125I brachytherapy for recurrent high-grade astrocytomas. Int J Radiat Oncol Biol Phys. 1996;35:541–7.

    Article  PubMed  CAS  Google Scholar 

  50. Loeffler JS, Alexander 3rd E, Hochberg FH, et al. Clinical patterns of failure following stereotactic interstitial irradiation for malignant gliomas. Int J Radiat Oncol Biol Phys. 1990;19:1455–62.

    Article  PubMed  CAS  Google Scholar 

  51. Aiken AH, Chang SM, Larson D, Butowski N, Cha S. Longitudinal magnetic resonance imaging features of glioblastoma multiforme treated with radiotherapy with or without brachytherapy. Int J Radiat Oncol Biol Phys. 2008;72:1340–6.

    Article  PubMed  Google Scholar 

  52. Hohwieler ML, Lo TC, Silverman ML, et al. Brain necrosis alter radiotherapy for primary intracerebral tumor. Neurosurgery. 1986;18:67–74.

    Article  PubMed  CAS  Google Scholar 

  53. Van Tassel P, Bruner JM, Maor MH, et al. MR of toxic effects of accelerated fractionation radiation therapy and carboplatin chemotherapy for malignant gliomas. Am J Neuroradiol. 1995;16:715–26.

    PubMed  Google Scholar 

  54. Chen AM, Chang S, Pouliot J, et al. Phase I trial of gross total resection, permanent Iodine-125 brachytherapy, and hyperfractionated radiotherapy for newly diagnosed glioblastoma multiforme. Int J Radiat Oncol Biol Phys. 2007;69:825–30.

    Article  PubMed  CAS  Google Scholar 

  55. Patel S, Breneman JC, Warnick RE, et al. Permanent iodine-125 implants for the treatment of recurrent glioblastoma multiforme. Neurosurgery. 2000;46:1123–30.

    Article  PubMed  CAS  Google Scholar 

  56. Scharfen CO, Sneed PK, Wara WM, et al. High activity iodine-125 interstitial implant for gliomas. Int J Radiat Oncol Biol Phys. 1992;24:583–91.

    Article  PubMed  CAS  Google Scholar 

  57. Shrieve DC, Alexander 3rd E, Black PM, Wen PY, Fine HA, Kooy HM, et al. Treatment of patients with primary glioblastoma multiforme with standard postoperative radiotherapy and radiosurgical boost: prognostic factors and long-term outcome. J Neurosurg. 1999;90:72–7.

    Article  PubMed  CAS  Google Scholar 

  58. Mehta MP, Masciopinto J, Rozental J, et al. Stereotactic radiosurgery for glioblastoma multiforme: Report of a prospective study evaluating prognostic factors and analyzing long-term survival advantage. Int J Radiat Oncol Biol Phys. 1994;30:541–9.

    PubMed  CAS  Google Scholar 

  59. Matsutani M. Intraoperative radiation therapy for malignant brain tumors. In: Dobelbower Jr RR et al., editors. Intraoperative radiation therapy. Boca Raton: CRC; 1989. p. 137–58.

    Google Scholar 

  60. Nakamura O, Matsutani M, Shitara N, et al. New treatment protocol by intraoperative radiation therapy for metastatic brain tumors. Acta Neurochir (Wien). 1994;131:91–6.

    Article  CAS  Google Scholar 

  61. Combs SE, Thilmann C, Edler L, Debus J, Schulz-Ertner D. Efficacy of fractionated stereotactic reirradiation in recurrent gliomas: long-term results in 172 patients treated in a single institution. J Clin Oncol. 2005;34:8863–9.

    Article  Google Scholar 

  62. Cho KH, Hall WA, Gerbi BJ, Higgins PD, McGuire WA, Clark HB. Single dose versus fractionated stereotactic radiotherapy for recurrent high-grade gliomas. Int J Radiat Oncol Biol Phys. 1999;45:1133–41.

    Article  PubMed  CAS  Google Scholar 

  63. Gaspar L, Zamorano L, Shamsa F, Fontanesi V, Ezzell G, Yakar D. Permanent 125-iodine implants for recurrent malignant gliomas. Int J Radiat Oncol Biol Phys. 1999;43:977–82.

    Article  PubMed  CAS  Google Scholar 

  64. Schrieve DC, Alexander 3rd E, Wen PY, et al. Comparison of stereotactic radiosurgery and brachytherapy in the treatment of recurrent glioblastoma multiforme. Neurosurgery. 1995;36:275–82.

    Article  Google Scholar 

  65. Hall WA, Djalilian HR, Sperduto PW, et al. Stereotactic radiosurgery for recurrent malignant gliomas. J Clin Oncol. 1995;13:1642–8.

    PubMed  CAS  Google Scholar 

  66. Kong DS, Lee JI, Park K, Kim JH, Lim DH, Nam DH. Efficacy of stereotactic radiosurgery as a salvage treatment for recurrent malignant gliomas. Cancer. 2008;112:2046–51.

    Article  PubMed  Google Scholar 

  67. Leibel SA, Gutin PH, Wara WM, et al. Survival and quality of life after interstitial implantation of removable high-activity iodine-125 sources for the treatment of patients with recurrent malignant gliomas. Int J Radiat Oncol Biol Phys.1989;17:1129–39.

    Google Scholar 

  68. Greenblatt SH, Rayport M. Neurosurgical considerations in intraoperative radiation therapy. In: Dobelbower RR, Abe M, editors. intraoperative radiation therapy. Boca Raton: CRC; 1989. p. 123–36.

    Google Scholar 

  69. Abe M, Takahashi M, Yabumoto E, Adachie H, Yoshii M, Mori K. Clinical experiences with intraoperative radiotherapy of locally advanced cancers. Cancer. 1986;45:40–8.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David Ortiz de Urbina .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

de Urbina, D.O., Schueller, P., Willich, N., Takakura, K., Kubo, O., Calvo, F.A. (2011). Central Nervous System Tumors. In: Gunderson, L., Willett, C., Calvo, F., Harrison, L. (eds) Intraoperative Irradiation. Current Clinical Oncology. Humana Press. https://doi.org/10.1007/978-1-61779-015-7_8

Download citation

  • DOI: https://doi.org/10.1007/978-1-61779-015-7_8

  • Published:

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-61779-014-0

  • Online ISBN: 978-1-61779-015-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics