Removable, adjustable and reusable implants for stereotactic interstitial radiosurgery of brain tumors

Sixty primary brain tumors (gliomas) were treated by interstitial radiosurgery using 192Ir according to a protocol based on the size of the tumor. In all cases, the radioactive wires were left in place for periods ranging from 5 to 10 days, according to dosimetry calculations, and then removed, which was made possible by the use of removable implants. The stainless steel tubes are occluded on their inner side and adjustable in length depending on the depth of the tumor, and are introduced through screws inserted into the skull in an array depending on the preliminary dosimetry. The tubes were afterloaded with 192Ir and removed at the end of the calculated time. Forty-six patients (18 low-grade and 28 malignant gliomas) were treated using this method. One small hematoma was evacuated and no sepsis occurred.