GliaSite Brachytherapy Boost as Part of Initial Treatment of Glioblastoma Multiforme: A Retrospective Multi-Institutional Pilot Study

Imaging After GliaSite Brachytherapy: Prognostic MRI Indicators of Disease Control and Recurrence

“…The GliaSite RTS has now been used to treat recurrent high-grade glioma, primary high-grade glioma (as a boost), and brain metastases in the adjuvant setting (10)(11)(12)(13). The treatment of recurrent glioblastoma after repeat resection has resulted in survival that is favorable compared with that after surgery alone.…”

Treatment of Glioblastoma in “Elderly” Patients

“…Technical improvements in radiation therapy delivery and planning during the 1980's and 1990's, including the development of 3-D conformal radiation therapy, stereotactic radiosurgery, and intensity-modulated radiation therapy, prompted the development of several dose-escalation protocols for the treatment of malignant gliomas. Unfortunately, none of the reported dose-escalation, radiosurgery, or brachytherapy boost protocols have shown a clear benefit to increasing the radiation dose beyond 60 Gy, which remains the standard of care today [16][17][18].…”

Controversies concerning the application of brachytherapy in central nervous system tumors

“…As this bold speculation has not been proved yet, both techniques are worthy of further evaluation, especially the newly emerging Glia-Site temporary BRT technique which has shown very encouraging results in both recurrent and primary glioma treatment (Table 1) (Chan et al 2005;Gabayan et al 2006;Tatter et al 2003;Welsh et al 2007). …”

“…Additionally, both the two trials have used 125I seed implants, with which the inhomogeneity associated may in turn led to increased rates of radiation necrosis; and the seed implantation technique itself was technically challenging, usually requiring a second operation to place the seeds (Welsh et al 2007). …”

“…These characteristics give Glia-Site BRT unique advantages in treating tumors with highest risk of recurrence. And this might partially explain why BRT is still relevant in the setting of prospective randomized studies which have failed to demonstrate a beneWt in primary malignant gliomas, that recurrent gliomas may be best suited for BRT vs. other modalities (Bernstein et al 1994;Chan et al 2005;Combs et al 2005Combs et al , 2007Gabayan et al 2006;Larson et al 2004;Shaw et al 2000;Shrieve et al 1995;Tatter et al 2003Tatter et al , 2007Welsh et al 2007). …”