Microwave hyperthermia radiosensitized iridium-192 for recurrent brain malignancy

Journal Article · Tue Mar 01 04:00:00 EST 1988 · Medical Dosimetry; (USA)

OSTI ID:5402289

Borok, T L; Winter, A; Laing, J; Paglione, R; Sterzer, F; Sinclair, I; Plafker, J ^[1]

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1. Metcalf Institute-Radiation Oncology, Orange, NJ (USA)

Twenty-one patients whose solitary detectable biopsy proven recurrent brain malignancies produced Central Nervous System (CNS) symptoms warranting further intervention received 60-minute 43 degrees C (180 degree-minute) interstitial 2450 MHz microwave hyperthermia fractions. All received brain teletherapy prior to recurrence. The first 15 received no brachytherapy and served as a toxicity pilot. All 15 enjoyed neurologic improvement, 12 symptomatic improvement, and 12 objective response as mass reduction and/or tumor necrosis. The next 6 patients were selected with more favorable Karnofsky performance status, no known active malignancy elsewhere, and received afterloading Ir-192 interstitial implantation juxtaposed to radiosensitizing hyperthermia. Volume dose varied from 1000 to 2245 rad, and dose rate from 40 to 100 rad/hr. Dose selected varied as a function of pre-recurrence teletherapy dose, general condition, histologic type, and volume. Neurosurgical debulking, if technically indicated through no additional aperture or trauma, was permitted if consistent with preservation of neurological function. Six enjoyed neurologic improvement, symptom reduction, and objective tumor response; three remain alive, and one experienced transient improvement. Complications, histologic subtypes, autopsy findings, stereotactic approach, thermal monitoring methods and CT follow-up of objective response are presented along with computer dosimetry and isotherm chart. Our microtraumatic universal catheter technique for CT guided stereotactic biopsy, aspiration, decompression, thermal sensory loop, thermalization antennae, and brachytherapy without multiple trauma nor changing catheters is stressed. The rationale for combined modes peculiar to the CNS will be outlined.2+ Proposal for incorporating controlled-release ARA-C chemotherapy polymer micro-rods into the interstitial format will be offered.

• OSTI ID: 5402289
• Journal Information: Medical Dosimetry; (USA), Journal Name: Medical Dosimetry; (USA) Vol. 13:1; ISSN 0739-0211; ISSN MEDOE
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ANIMALS
BIOLOGICAL EFFECTS
BODY
BODY TEMPERATURE
BRAIN
CENTRAL NERVOUS SYSTEM
DISEASES
DOSES
ELECTROMAGNETIC RADIATION
HYPERTHERMIA
IMPLANTS
MAMMALS
MAN
MEDICINE
MICROWAVE RADIATION
NEOPLASMS
NERVOUS SYSTEM
NUCLEAR MEDICINE
ORGANS
PRIMATES
RADIATION DOSES
RADIATION SOURCE IMPLANTS
RADIATION SOURCES
RADIATIONS
RADIOLOGY
RADIOSENSITIVITY EFFECTS
RADIOTHERAPY
THERAPY
VERTEBRATES