Neutron interstitial brachytherapy for malignant gliomas: a pilot study

Journal Article · Thu Dec 31 23:00:00 EST 1987 · J. Neurosurg.; (United States)

DOI:https://doi.org/10.3171/jns.1988.68.1.0067· OSTI ID:5557293

Patchell, R A; Maruyama, Y; Tibbs, P A; Beach, J L; Kryscio, R J; Young, A B

Fifty-six patients with malignant glioma were treated with implantation of the neutron-emitting element californium-252 (/sup 252/Cf) within 2 weeks after surgical debulking of the tumor. Implantation was performed using computerized tomography-guided placement of afterloading catheters, and the /sup 252/Cf sources were removed after approximately 300 neutron rads were delivered. Patients then received 6000 to 7000 conventional photon rads by external beam. The total photon-equivalent dose to the tumor ranged from 8100 to 9100 rads. The median survival time was 10 months, with 18-and 24-month survival rates of 28% and 19%, respectively. The results of reoperation or autopsy showed that patients had recurrence of the tumor but that radiation necrosis was restricted to the area of the original tumor. Serious complications occurred in five patients (9%) and consisted of wound infections in three, cerebral edema in one, and radiation necrosis beyond the original tumor margin in one. Previous studies using external-beam neutron radiation have shown that neutrons are capable of totally eradicating malignant gliomas; however, in most cases, unacceptable widespread radiation necrosis has resulted. Neutron implants are a logical way to increase the dose to the tumor and decrease the dose to normal brain. Interstitial neutron radiation can be given safely with /sup 252/Cf, and the survival results achieved by radiation alone using relatively low doses of interstitial neutron radiation from /sup 252/Cf implants plus conventional photon radiation were equal to the results attained with any currently available conventional therapy.

• Research Organization: Univ. of Kentucky Medical Center, Lexington
• OSTI ID: 5557293
• Journal Information: J. Neurosurg.; (United States), Journal Name: J. Neurosurg.; (United States) Vol. 68:1; ISSN JONSA
• 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.
ACTINIDE ISOTOPES
ACTINIDE NUCLEI
ALPHA DECAY RADIOISOTOPES
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
BRAIN
CALIFORNIUM 252
CALIFORNIUM ISOTOPES
CAPTURE
CENTRAL NERVOUS SYSTEM
DISEASES
DOSES
EVEN-EVEN NUCLEI
GLIOMAS
HEAVY NUCLEI
IMPLANTS
INJURIES
ISOTOPES
MEDICINE
NEOPLASMS
NERVOUS SYSTEM
NUCLEAR MEDICINE
NUCLEI
ORGANS
PATIENTS
RADIATION DOSES
RADIATION EFFECTS
RADIATION INJURIES
RADIATION SOURCE IMPLANTS
RADIATION SOURCES
RADIOISOTOPES
RADIOLOGY
RADIOTHERAPY
SIDE EFFECTS
SURVIVAL CURVES
THERAPY
YEARS LIVING RADIOISOTOPES