Template-guided stereotactic implantation of malignant brain tumors for interstitial thermoradiotherapy

A phase I trial of 25 patients with anaplastic astrocytoma or glioblastoma multiforme is described. Hyperthermia and radiation were delivered stereotactically by means of template-guided interstitial catheters loaded with ferromagnetic wires and then 192Ir seeds. Implant volumes ranged from 15 to 113 ml (mean 54 ml) involving 9-38 catheters (mean 18); parallel catheters used hexagonal spacing of 1.0-1.5 cm. Patient tolerance of these procedures was excellent. Postoperative morbidity due to additional mass effect or edema was low, but there has been one death and one complication of hydrocephalus, bleeding and symptomatic pneumocephalus, each.