Operation and permanent low activity 125I brachytherapy for recurrent high-grade astrocytomas

John B. Halligan, Keith J. Stelzer, Robert C. Rostomily, Alexander M. Spence, Thomas W. Griffin, Mitchel S. Berger

Research output: Contribution to journalArticle

50 Scopus citations

Abstract

Twenty-two adult patients with recurrent high grade astrocytomas [18 glioblastoma multiforme (GBM) and 4 anaplastic astrocytoma (AA) at time of implant] underwent therapy at the University of Washington from October 1991 through March 1995, with repeat craniotomy, maximal debulking of tumor, and placement of permanent low activity 125I seeds. Median age was 41 years and median Karnofsky performance status was 90. Median survival for the entire group was 65 weeks from the time of implant. For the subgroup of GBM patients, median survival was 64 weeks from the time of implant. One-year survival from the date of implant was 57% for the entire group and 59% for those with GBM. The site of first failure after implant was local (within 2 cm of the resection cavity) in 70%, distant (noncontiguous, beyond 2 cm) in 18% and concurrently local and distant in 12%. There was one case of symptomatic radiation injury that resolved with steroid therapy, and no patient required repeat craniotomy for parenchymal necrosis. For patients with recurrent GBM, treatment with resection anti permanent low activity 125I brachytherapy yielded improved survival compared to an internal historical control group treated with resection and chemotherapy (p = 0.023). Craniotomy with maximal tumor debulking and placement of low activity 125I seeds yields encouraging results with minimal morbidity in patients with recurrent high-grade astrocytomas.

Original languageEnglish (US)
Pages (from-to)541-547
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume35
Issue number3
DOIs
StatePublished - Jun 1 1996

Keywords

  • Glioblastoma multiforme (GBM)
  • High-grade astrocytomas
  • I brachytherapy

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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