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Intraoperative radiotherapy for gliomas

T Fujiwara¹, Y Honma, T Ogawa

¹Department of Neurological Surgery, Kagawa Medical School, Japan.

Journal of Neuro-Oncology

|January 1, 1995

Summary

Intraoperative radiotherapy (IORT) improved survival for glioma patients. This advanced radiation technique offers benefits for malignant glioma treatment despite potential complications.

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Area of Science:

Neurosurgery
Radiation Oncology
Oncology

Background:

Gliomas are primary brain tumors with varying degrees of malignancy.
Standard treatments often involve surgery, external beam radiotherapy, and chemotherapy.
Intraoperative radiotherapy (IORT) presents a potential adjunct to improve local tumor control.

Purpose of the Study:

To evaluate the efficacy and safety of intraoperative radiotherapy (IORT) in patients with glioma.
To compare survival outcomes between patients receiving IORT and a control group.

Main Methods:

IORT was administered to 20 of 36 glioma patients (11 glioblastomas, 7 malignant astrocytomas, 2 benign astrocytomas).
Doses of 20 or 25 Gy were delivered in a single intraoperative fraction, followed by external beam irradiation.

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Electron beam energy was optimized to target residual tumor margins at 2-3 cm depth.

Main Results:

Median survival time was 14 months for the IORT group versus 10 months for the control group, a statistically significant difference.
Six complications related to IORT were observed: 1 radionecrosis, 1 convulsion, 1 abscess, and 3 severe brain edemas.
The study included patients with glioblastoma, malignant astrocytoma, and benign astrocytoma.

Conclusions:

Intraoperative radiotherapy (IORT) demonstrates a significant survival benefit for patients with malignant gliomas.
While complications can occur, IORT is a suitable treatment modality for malignant gliomas.
Further research may explore optimizing IORT techniques to minimize adverse events.