Stereotactic interstitial radiotherapy for brain tumors.

Area of Science:

• Neurosurgery
• Radiation Oncology
• Oncology

Background:

• Conventional radiotherapy (teletherapy) faces limitations due to the narrow therapeutic window between tumor and healthy brain sensitivity to radiation.
• Interstitial radiotherapy, specifically brachytherapy with iodine-125 (I-125) permanent implants, has emerged as an effective method for local tumor control.

Purpose of the Study:

• To evaluate the efficacy and safety of interstitial radiotherapy using I-125 implants for various brain tumors located in functionally critical areas.
• To determine the suitability of I-125 brachytherapy for specific tumor types, particularly differentiated gliomas.

Main Methods:

• Retrospective analysis of 179 patients treated with interstitial radiotherapy using low activity permanent or temporary I-125 implants.
• Tumor types included differentiated gliomas (132 cases), anaplastic gliomas and glioblastomas (16 cases), ependymomas and papillomas (4 cases), and other extracerebral tumors (27 cases).
• Treatments were performed for tumors located in functionally critical cortical or deep-seated areas.

Main Results:

• Iodine-125 brachytherapy demonstrated effectiveness in achieving local tumor control for a range of brain tumors.
• The procedure allows for radiosurgical tumor removal while minimizing radiation and operative damage to surrounding healthy brain tissue.
• The study included a significant number of patients with differentiated gliomas, highlighting the technique's applicability to this specific tumor type.

Conclusions:

• Interstitial brachytherapy with I-125 implants is recommended for slowly proliferating, differentiated, non-resectable tumors situated in functionally critical brain areas.
• The technique facilitates precise tumor ablation with reduced risk to adjacent healthy brain tissue.
• Individualized treatment approaches, supported by experimental and clinical data, are desirable for optimizing patient outcomes.