Preliminary Results of Interstitial &lt;SUP&gt;192&lt;/SUP&gt;Ir Brachytherapy for Malignant Gliomas

Matsumoto, Kengo; Nakagawa, Minoru; Higashi, Hisato; Maeshiro, Tomohide; Tsuno, Kazuyuki; Mishima, Nobuya; Furuta, Tomohisa; Ohmoto, Takashi; Taguchi, Kohji; Nakagawa, Tomio; Hiraki, Yoshio

doi:10.2176/nmc.32.739

Cited by 11 publications

(3 citation statements)

References 25 publications

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“…The reactive gliosis has been noted to be proliferative in one BUdR study following gamma radiation in rats [28]; however, the proliferative index, as determined with the anti-Ki-67 mAb, indicates the index is less than 1% in benign post-radiation reactive gliosis exclusive of proliferative endothelial cells and macrophages.…”

Section: Discussionmentioning

confidence: 96%

Tumor resection cavity administered iodine-131-labeled antitenascin 81C6 radioimmunotherapy in patients with malignant glioma: neuropathology aspects

McLendon

Akabani

Friedman

et al. 2007

Nuclear Medicine and Biology

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Introduction-The neurohistological findings in patients treated with targeted β emitters such as 131 I are poorly described. We report a histopathologic analysis from patients treated with combined external beam therapy and a brachytherapy consisting of a 131 I-labeled monoclonal antibody (mAb) injected into surgically created resection cavities during brain tumor resections.Methods-Directed tissue samples of the cavity walls were obtained because of suspected tumor recurrence from 28 patients. Samples and clinical follow-up were evaluated on all patients (Group A) based on total radiation dose received and a subset of these (n=18; Group B, proximal therapy subset) who had received external beam therapy within ≤3 months of mAb therapy, and undergoing 26 biopsies over 37 months. Histologic outcomes were "proliferative glioma", "quiescent glioma" and negative for neoplasm. Statistical analysis was used to assess the casual relation between total absorbed dose ( 131 I-mAb + external beam) and histologic diagnosis. Results-The lesions observed after 131 I-mAb therapy were qualitatively similar to those reported for other types of radiation therapy; however, the high localized dose rate and absorbed doses produced by the short range of 131 I β particles seem to have resulted in an earlier necrotic reaction in the tumor bed. Among all 28 (Group A) patients, median survival from tissue analysis post mAb therapy depended on histopathology and total radiation absorbed dose. Median survival for patients with tissue classified as proliferative glioma, quiescent glioma, and negative for neoplasm were 3.5, 15, and 27.5 months, respectively. Without categorization, total dose was a significant predictor of survival (p < 0.002) where patients with higher doses had better prognoses. For example, median

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Section: Discussionmentioning

confidence: 96%

Tumor resection cavity administered iodine-131-labeled antitenascin 81C6 radioimmunotherapy in patients with malignant glioma: neuropathology aspects

McLendon

Akabani

Friedman

et al. 2007

Nuclear Medicine and Biology

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“…In addition, it is carried out for primary and recurrent cancer at various tumour sites, e.g. for breast (Delanian et al, 1992), bronchial (Delclos et al, 1996), and hepatic (Minsky et al, 1992) carcinoma, sarcoma of the brain (Matsumoto et al, 1992) and soft tissue (Habrand et al, 1991), and as adjuvant in therapy of rhabdomyosarcoma of children (Nag et al, 1993).…”

Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasound-guided brachytherapy of head and neck tumours. A new procedure for controlled application

Maier

Henne²,

Krebs

et al. 1999

J. Laryngol. Otol.

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Brachytherapy is an established procedure in primary and in recurrent cancer. We perform afterloading brachytherapy during general anaesthesia. The target organ is punctured with hollow needles which are loaded with 192iridium via remote control. The depth and number of needles depend on tumour extension. In the interdisciplinary approach of our departments, this method has been improved and supplied by B-scan ultrasound control. Needles are positioned under continuous ultrasonographic guidance, and adjacent structures (e.g. the carotid artery) are localized ultrasonographically. Thus violation of the large vessels is avoided and the exact position of the needles within the tumour is improved.In this paper, we report results on 22 patients suffering from recurrent carcinoma of the head and neck following surgery and curative radiation, and 17 patients with first onset of cancer. We did not observe any severe complications such as haemorrhage, osteomyelitis, or dyspnoea. The only side-effect was temporary oedema, sometimes associated with a short-term increase of pain. No systemic side-effects occurred.The method is described and results from both patient groups are reported in detail. We conclude from our data that ultrasonographically-controlled endoscopic brachytherapy is a valuable procedure in locally-advanced primary, and in recurrent head and neck cancer.

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“…This technique has been applied to 52 cases of malignant brain tumour and to a series of three patients with pineal region tumours for the purpose of obtaining a debulking effect. The operative procedure has been described previously [17].…”

Section: Methodsmentioning

confidence: 99%

Pineal region tumours treated with interstitial brachytherapy with low activity sources (192-iridium)

et al. 1995

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Three patients with tumours of the pineal region underwent interstitial Ir-192 brachytherapy. Histological diagnoses were obtained in all patients, by stereotactic biopsy and included one germinoma, one mixed pineoblastoma/pineocytoma, and one astrocytoma grade III. Our approach to pineal region neoplasms is first to decide whether stereotactic biopsy or surgery should be performed. When a pineal lesion is thought to be benign on the basis of imaging, such as benign teratoma, surgery is performed to resect the entire lesion. When a definitive diagnosis is not possible, stereotactic biopsy is performed to obtain a histological diagnosis for treatment planning, using a Brown-Roberts-Wells (BRW) stereotactic apparatus with computed tomography (CT) or magnetic resonance imaging (MRI). When a lesion is malignant and localized, stereotactic implantation of catheters for interstitial brachytherapy is performed simultaneously. Radioactive Ir-192 seeds are inserted into the catheters and maintained for 5-10 days to give 36 Gy of irradiation at the tumour periphery. Sequential CT scans and MRI after treatment revealed tumour disappearance in two patients with germinoma and high grade astrocytoma and tumour reduction in the patient with mixed pineoblastoma/pineocytoma. No significant morbidity or mortality occurred in any of these patients after stereotactic biopsy and brachytherapy. The technique and the advantages of this therapeutic approach to selected pineal region tumours are described and discussed.

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Preliminary Results of Interstitial <SUP>192</SUP>Ir Brachytherapy for Malignant Gliomas

Cited by 11 publications

References 25 publications

Tumor resection cavity administered iodine-131-labeled antitenascin 81C6 radioimmunotherapy in patients with malignant glioma: neuropathology aspects

Tumor resection cavity administered iodine-131-labeled antitenascin 81C6 radioimmunotherapy in patients with malignant glioma: neuropathology aspects

Endoscopic ultrasound-guided brachytherapy of head and neck tumours. A new procedure for controlled application

Pineal region tumours treated with interstitial brachytherapy with low activity sources (192-iridium)

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