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Long-Term Follow-Up of Brachytherapy in Untreated Malignant Glioma

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Journal of Radiosurgery

Abstract

Objective: Long-term follow-up of patients with malignant glioma randomized to treatment with and without brachytherapy. Methods: Twenty-six patients were randomized to brachytherapy and external radiation, and 23 to external radiation alone. There were 19 and 17 glioblastomas, and 3 and 8 anaplastic astrocytomas, in the nonimplant and implant groups, respectively, and 1 malignant oligodendroglioma in each group. For brachytherapy, iodine- 125 seeds were implanted to deliver a homogeneous dose of 40 cGy/hr for a maximum of 6000 cGy to the enhancing tumor margin. All patients received external radiation for a total of 6020 cGy delivered to the tumor plus 3 cm margin over 7 weeks, followed by BCNU chemotherapy. Conclusions: The median survival was 78 and 66 weeks in the implant and nonimplant groups respectively, and their survival curves were not different (log rank, p=0.394). A significant multivariate relationship did exist between survival and age (p=0.0092), tumor grade (p=0.0001), and Karnofsky (p=0.021). Treatment with brachytherapy is subject to selection bias, which does exclude a large proportion of patients.

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REFERENCES

  1. Bernstein M, Gutin P: Interstitial irradiation of brain tumors: A review. Neurosurgery 9(6):741–750, 1981

    Google Scholar 

  2. Bernstein M, Laperrierre N, Leung P, McKenzie S: Interstitial brachytherapy for malignant brain tumors: Preliminary results. Neurosurgery 26(3):371–380, 1990

    Google Scholar 

  3. Florell R, Macdonald D, Irish M, Bernstein M, Leibel S, Gutin P, Cairncross G: Selection bias, survival, and brachytherapy for glioma. J Neurosurg 76:179–183, 1992

    Google Scholar 

  4. Gutin P, Leibel S, Wara W, Choucair A, Levin V, Philips T, Silver P, Silva V, Edwards M, Davis R, Weaver K, Lamb S: Recurrent malignant gliomas: Survival following interstitial brachytherapy with high-activity iodine-125 sources. J Neursurg 67:864–873, 1987

    Google Scholar 

  5. Gutin P, Philips T, Wara W, Leibel S, Hosobuchi Y, Levin V, Weaver K, Lamb S: Brachytherapy of recurrent malignant brain tumors with removable high-activity iodine-125 sources. J Neurosurg 60:61–68, 1984

    Google Scholar 

  6. Hall E: Radiosensitivity and cell age in the mitotic cycle (chapter 6). In Hall E (ed), Radiobiology for the Radiologist. Philadelphia, PA: JB Lippincott Company, 1994, pp. 91–105

    Google Scholar 

  7. Hall E: The oxygen effect and reoxygenation (chapter 8). In Hall E (ed), Radiobiology for the Radiologist. Philadelphia, PA: JB Lippincott Company, 1994, pp. 133–152

    Google Scholar 

  8. Hall E, Cavanagh J: The oxygen effect for acute and protracted radiation exposures measured with seedlings of Vicia faba. Br J Radiobiol 40:128–133, 1967

    Google Scholar 

  9. Hitchon P, VanGilder J, Jani S, Wen B, Neeranjun W: Brachytherapy for malignant gliomas. Cont Neursurg 16(20):1–6, 1994

    Google Scholar 

  10. Laperriere NJ, Leung MK, McKenzie S: Randomized study of brachytherapy in the initial management of patients with malignant astrocytoma. Int J Radiation Oncol Biol Phys 41:1005–1011, 1998

    Google Scholar 

  11. Loeffler J, Alexander E, Wen P, Shea M, Coleman N, Kooy H, Fine H, Nedzi L, Silver B, Riese N, Black P: Results of stereotactic brachytherapy used in the initial management of patients with glioblastoma. J Natl Cancer Inst 82(24):1918–1921, 1990

    Google Scholar 

  12. Mundinger F: The treatment of brain tumors with radioisotopes. Progr Neurol Surg 1:202–257, 1966

    Google Scholar 

  13. Mundinger F: Implantation of radioisotopes (Curie-therapy). In Schaltenbrand G, Walker E, Hassler R, Narabayashi H, Riechert T, (eds), Stereotaxy of the Human Brain: Anatomical, Physiological and Clinical Applications. New York: Thieme-Stratton, 1982, pp. 410–435

    Google Scholar 

  14. Selker R, Eddy M, Deutsch M, Arena V, Burger P: On the development of an interstitial radiation protocol for a multicenter consortium. Experience with permanent low-dose rate and temporary high-dose rate 125 I implants in “failed” and “newly diagnosed” glioblastoma patients: Quality assurance methodology and a possible future adjuvant for therapeutic enhancement. J Neuro-Oncol 26:141–155, 1995

    Google Scholar 

  15. Sheline G, Wara W, Smith V: Therapeutic irradiation and brain injury. J Radiat Oncol Biol Phys 6:1215–1228, 1980

    Google Scholar 

  16. Shrieve D, Alexander E, Wen P, Fine H, Kooy H, Black P, Loeffler J: Comparison of stereotactic radiosurgery and brachytherapy in the treatment of recurrent glioblastoma multiforme. Neurosurgery 36(2):275–284, 1995

    Google Scholar 

  17. Walker M, Alexander E, Hunt W, MacCarty C, Mahaley S, Mealey J, Norrell H, Owens G, Ransohoff J, Wilson C, Gehan E, Strike T: Evaluation of BCNU and/or radiotherapy in the treatment of anaplastic gliomas. J Neurosurg 49:333–343, 1978

    Google Scholar 

  18. Walker M, Strike T, Sheline G: An analysis of dose-effect relationship in the radiotherapy of malignant gliomas. Int J Radiat Oncol Biol Phys 5:1725–1731, 1979

    Google Scholar 

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Correspondence to P. W. Hitchon.

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Hitchon, P.W., Schneider, P., VanGilder, J.C. et al. Long-Term Follow-Up of Brachytherapy in Untreated Malignant Glioma. Journal of Radiosurgery 2, 129–133 (1999). https://doi.org/10.1023/A:1022914612628

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  • DOI: https://doi.org/10.1023/A:1022914612628

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