Operation and permanent low activity I-125 brachytherapy for recurrent high-grade astrocytomas

被引:37
作者
Halligan, JB
Stelzer, KJ
Rostomily, RC
Spence, AM
Griffin, TW
Berger, MS
机构
[1] UNIV WASHINGTON,MED CTR,DEPT RADIAT ONCOL,SEATTLE,WA 98195
[2] UNIV WASHINGTON,MED CTR,DEPT NEUROL SURG,SEATTLE,WA 98195
[3] UNIV WASHINGTON,MED CTR,DIV NEUROL,SEATTLE,WA 98195
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 1996年 / 35卷 / 03期
关键词
high-grade astrocytomas; I-125; brachytherapy; glioblastoma multiforme (GBM);
D O I
10.1016/0360-3016(96)00094-6
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Twenty-two adult patients with recurrent high grade astrocytomas [18 glioblastoma multiforme (GBM) and 4 anaplastic astrocytoma (AA) at time of implant] underwent therapy at the University of Washington from October 1991 through March 1995, with repeat craniotomy, maximal debulking of tumor, and placement of permanent low activity I-125 seeds, Median age was 41 years and median Karnofsky performance status was 90, Median survival for the entire group was 65 weeks from the time of implant, For the subgroup of GBM patients, median survival was 64 weeks from the time of implant, One-year survival from the date of implant was 57% for the entire group and 59% for those with GBM. The site of first failure after implant was local (within 2 cm of the resection cavity) in 70%, distant (noncontiguous, beyond 2 cm) in 18% and concurrently local and distant in 12%, There was one case of symptomatic radiation injury that resolved with steroid therapy, and no patient required repeat craniotomy for parenchymal necrosis, For patients with recurrent GBM, treatment with resection and permanent low activity I-125 brachytherapy yielded improved survival compared to an internal historical control group treated with resection and chemotherapy (p = 0.023), Craniotomy with maximal tumor debulking and placement of low activity I-125 seeds yields encouraging results with minimal morbidity in patients with recurrent high-grade astrocytomas.
引用
收藏
页码:541 / 547
页数:7
相关论文
共 25 条
[1]   PATTERNS OF RECURRENCE OF MALIGNANT ASTROCYTOMA FOLLOWING STEREOTAXIC INTERSTITIAL BRACHYTHERAPY WITH I-125 IMPLANTS [J].
AGBI, CB ;
BERNSTEIN, M ;
LAPERRIERE, N ;
LEUNG, P ;
LUMLEY, M .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1992, 23 (02) :321-326
[2]   REOPERATION IN THE TREATMENT OF RECURRENT INTRACRANIAL MALIGNANT GLIOMAS [J].
AMMIRATI, M ;
GALICICH, JH ;
ARBIT, E ;
LIAO, Y .
NEUROSURGERY, 1987, 21 (05) :607-614
[3]   INTRAOPERATIVE BRAIN MAPPING TECHNIQUES IN NEUROONCOLOGY [J].
BERGER, MS ;
OJEMANN, GA .
STEREOTACTIC AND FUNCTIONAL NEUROSURGERY, 1992, 58 (1-4) :153-161
[4]   INTERSTITIAL BRACHYTHERAPY FOR MALIGNANT BRAIN-TUMORS - PRELIMINARY-RESULTS [J].
BERNSTEIN, M ;
LAPERRIERE, N ;
LEUNG, P ;
MCKENZIE, S .
NEUROSURGERY, 1990, 26 (03) :371-380
[5]  
DIRKS P, 1993, CAN J SURG, V36, P271
[6]   I125 INTERSTITIAL BRACHYTHERAPY FOR PRIMARY MALIGNANT BRAIN-TUMORS - TECHNICAL ASPECTS OF TREATMENT PLANNING AND IMPLANTATION METHODS [J].
FINDLAY, PA ;
WRIGHT, DC ;
ROSENOW, U ;
HARRINGTON, FS ;
MILLER, RW .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1985, 11 (11) :2021-2026
[7]   SELECTION BIAS, SURVIVAL, AND BRACHYTHERAPY FOR GLIOMA [J].
FLORELL, RC ;
MACDONALD, DR ;
IRISH, WD ;
BERNSTEIN, M ;
LEIBEL, SA ;
GUTIN, PH ;
CAIRNCROSS, JG .
JOURNAL OF NEUROSURGERY, 1992, 76 (02) :179-183
[8]   REOPERATION FOR RECURRENT GLIOBLASTOMA AND ANAPLASTIC ASTROCYTOMA [J].
HARSH, GR ;
LEVIN, VA ;
GUTIN, PH ;
SEAGER, M ;
SILVER, P ;
WILSON, CB .
NEUROSURGERY, 1987, 21 (05) :615-621
[9]   NONPARAMETRIC-ESTIMATION FROM INCOMPLETE OBSERVATIONS [J].
KAPLAN, EL ;
MEIER, P .
JOURNAL OF THE AMERICAN STATISTICAL ASSOCIATION, 1958, 53 (282) :457-481
[10]  
Kumar P P, 1988, Radiat Med, V6, P219