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Permanent 125iodine implants for recurrent malignant gliomas.
L E Gaspar1, L J Zamorano, F Shamsa
1Department of Radiation Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA. gasparl@karmanos.org
Summary
Permanent 125iodine implants show efficacy in treating recurrent malignant gliomas, offering reasonable survival rates with a low complication risk. Further research aims to optimize radiation dosage for improved outcomes in glioma patients.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Oncology
Background:
- Recurrent malignant gliomas pose significant treatment challenges.
- 125iodine brachytherapy is a potential therapeutic option.
Purpose of the Study:
- To evaluate the efficacy and toxicity of permanent 125iodine implants for recurrent malignant gliomas.
Main Methods:
- 59 patients with recurrent malignant gliomas received permanent 125iodine implants.
- Patient ages ranged from 13-74 years, with median ages of 47 (overall), 39 (non-GBM), and 53 (GBM).
- Median follow-up was 40 months.
Main Results:
- Median survival was 1.34 years overall (2.04 years for non-GBM, 0.9 years for GBM).
- Predictive factors for poor prognosis included GBM histology, age ≥60, target volume ≥17 cc, and specific tumor locations.
- Reoperations were performed in 40% of patients for various reasons, including tumor progression and complications.
Conclusions:
- Permanent 125iodine implants are associated with reasonable long-term survival and low complication rates in selected patients.
- The low incidence of radiation necrosis suggests potential for increased radiation dose delivery.
- Future strategies involve escalating dose rates or total doses for improved therapeutic impact.