Stereotactic interstitial brachytherapy of malignant astrocytomas with remarks on postimplantation computed tomographic appearance

Journal Article · Thu Sep 01 04:00:00 EDT 1988 · Neurosurgery; (United States)

DOI:https://doi.org/10.1227/00006123-198809000-00011· OSTI ID:6277636

Willis, B K; Heilbrun, M P; Sapozink, M D; McDonald, P R

Seventeen patients were treated with stereotactically implanted high activity iodine-125 seeds, 12 patients for recurrent malignant astrocytomas (Protocol I) and 5 patients for newly diagnosed glioblastomas (Protocol II). Total radiation dosage to the recurrent tumors in Protocol I, including prior external beam irradiation, averaged 13,500 cGy. In the follow-up period of 6 to 50 months, the survival rate was 93% at 6 months, 60% at 12 months, 50% at 18 months, and 38% at 24 months after implantation. In Protocol II, brachytherapy was used as an interstitial radiation boost to the conventional treatment of newly diagnosed glioblastomas. External beam therapy and interstitial brachytherapy provided 11,000 cGy to these tumors. In the follow-up period of 15 to 27 months, there was a 100% survival at 12 months, 75% at 18 months, and 25% at 24 months after implantation. Eight of our 17 patients required reoperation for persistent or recurrent mass lesions at 6 to 15 months postimplantation; 7 were found to harbor masses of radionecrosis containing nests of anaplastic astrocytes; 1 had frank tumor recurrence. Median survival in this group of patients requiring reoperation was 18.7 months postimplantation. In a review of postimplantation computed tomographic scans, significant mass effect and crossover of hypodensity or enhancement into the corpus callosum or opposite hemisphere were found to have prognostic significance; persistent areas of contrast enhancement and excessive peritumoral hypodensity did not.

• Research Organization: Univ. of Utah School of Medicine, Salt Lake City (USA)
• OSTI ID: 6277636
• Journal Information: Neurosurgery; (United States), Journal Name: Neurosurgery; (United States) Vol. 23:3; ISSN NRSRD
• Country of Publication: United States
• Language: English

Related Subjects

550602 -- Medicine-- External Radiation in Diagnostics-- (1980-)
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62 RADIOLOGY AND NUCLEAR MEDICINE
ASTROCYTOMAS
BETA DECAY RADIOISOTOPES
COMPUTERIZED TOMOGRAPHY
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DISEASES
DOSES
ELECTRON CAPTURE RADIOISOTOPES
GLIOMAS
IMPLANTS
INTERMEDIATE MASS NUCLEI
IODINE 125
IODINE ISOTOPES
IRRADIATION PROCEDURES
ISOTOPES
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
NUCLEI
ODD-EVEN NUCLEI
PATIENTS
POST-IRRADIATION EXAMINATION
RADIATION DOSES
RADIATION SOURCE IMPLANTS
RADIATION SOURCES
RADIOISOTOPES
RADIOLOGY
RADIOTHERAPY
SURVIVAL CURVES
THERAPY
TOMOGRAPHY