Interstitial brachytherapy for low-grade cerebral gliomas: Analysis of results in a series of 36 cases

Abstract

The results obtained with interstitial brachytherapy in thirty-six low-grade cerebral gliomas (2 pilocytic astrocytomas, 23 astrocytomas and 11 oligodendrogliomas) are reported (mean follow-up: 75 months, range 37-159). All tumours were situated in locations which did not call for surgical removal as the treatment of choice. Their volume ranged from 4 to 82 cc (m = 32); the Karnofsky performance status (KPS) of the treated patients lay between 0.60 and 0.90. The sources utilized (Iridium-192 in 32 cases and Iodine-125 in 4) were implanted permanently in 22 patients and temporarily in 14, using the Talairach stereotactic apparatus. The mean peripheral dose was 89.7 Gy for the permanent implants and and 42.8 Gy with a rate of 32.05 cGy/h for the temporary implants. External beam irradiation was added for tumour volumes greater than 35 cc (19 cases) on a second target volume extending 2 cm beyond the tumoural borders treated with interstitial irradiation. The survival estimates for the entire group showed a probability of 82.9% at 60 months, of 56.8% at 96, 39.4% at 120 (m.s.t.: 112 months). The quality of life in the treated patients was satisfactory, KPS never falling below a mean score of 0.70. The extent of the target volume turned out to be the most significant factor influencing survival at the multivariate analysis. Severe neurological impairment due to radionecrosis occurred in 4 patients (11%), three of them requiring surgical decompression.(ABSTRACT TRUNCATED AT 250 WORDS)

Glioma-related seizures in relation to histopathological subtypes: a report from the glioma international case–control study

“…Moreover, two series of patients with low-grade gliomas have shown a significant lower seizure frequency following interstitial brachytherapy [37, 38]. …”

A 31-Year-Old Woman With a Transformed Low-grade Glioma

“…Several groups have studied the radiobiology of interstitial radiosurgery, and the 5-and 10-year median survival rates in both adult and pediatric low-grade gliomas rival those of surgery and radiotherapy. 11,62,71,73,74 Again, like open surgery, interstitial stereotactic radiosurgery is reported by single institutions, thereby increasing the likelihood of selection bias.…”

Epilepsy and brain tumors

“…Retrospective studies in low-grade gliomas indicate a 50% reduction in seizure frequency of 56–77% and a seizure freedom of 38–80% (Scerrati et al, 1994; Warnke et al, 1997; Shankar and Rajshekhar, 2003; Ruda et al, 2013). In a series of combined low- and high-grade gliomas, 77% of patients showed 50% seizure reduction and 38% seizure freedom at 12 months following radiation therapy, although patients could not discontinue AEDs (Ruda et al, 2013).…”