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Extraneural metastatic glioblastoma after interstitial brachytherapy
S C Houston1, I R Crocker, D J Brat
1Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA.
International Journal of Radiation Oncology, Biology, Physics
|October 6, 2000
Summary
Interstitial radiation therapy for glioblastoma may increase the risk of extraneural metastasis. This study found a 3.7% incidence of metastasis in patients receiving brachytherapy, suggesting a potential link.
Area of Science:
- Neuro-oncology
- Radiation Oncology
- Medical Imaging
Background:
- Glioblastoma is an aggressive primary brain tumor.
- Extraneural metastasis from glioblastoma is rare.
- Interstitial brachytherapy is a treatment modality for malignant brain tumors.
Observation:
- Three cases of extraneural glioblastoma metastasis were identified in 82 patients treated with interstitial (125)I brachytherapy.
- Metastases occurred in the scalp, skull, and cervical lymph nodes.
- No extraneural metastases were observed in 310 patients treated without brachytherapy during the same period.
Findings:
- The incidence of extraneural metastasis in this series was 3.7% (3/82).
- This incidence is comparable to previously reported rates (0%–4.3%).
- Patients treated with brachytherapy developed metastases at 3-8 months post-treatment.
Implications:
- Percutaneous catheter-delivered brachytherapy may be associated with an increased risk of extraneural metastatic glioma.
- Further research is warranted to confirm this association and elucidate the underlying mechanisms.
- Clinical vigilance for extraneural spread is recommended in patients undergoing this therapy.