Stereotactic iodine-125 brachytherapy for treatment of inoperable focal brainstem gliomas of WHO grades I and II: feasibility and long-term outcome.

Journal of Neuro-oncology
Maximilian I RugeV Sturm

Abstract

Microsurgical resection is the most frequently suggested treatment option for accessible focal brainstem gliomas (F-BSG) of World Health Organization (WHO) grades I and II. Because of their location in the highly eloquent brain, however, resection is associated with permanent postoperative morbidity, ranging from 12 to 33 %. Only a few reports have suggested stereotactic brachytherapy (SBT) with implantation of iodine-125 seeds as a local treatment alternative. Between 1993 and 2010, 47 patients were treated with SBT (iodine-125 seeds; cumulative surface dose 50-65 Gy) for inoperable F-BSG, WHO grades I and II, in one of the largest reported patient series. We evaluated procedure-related complications, clinical outcome, and progression-free and overall survival (PFS, OS). Median follow-up was 81.6 months. Procedure-related mortality was zero. Within 30 days of seed implantation six patients (12.8 %) had transient neurological deficits. Two patients (4.3 %) deteriorated permanently. Space-occupying cysts occurred in six patients (12.8 %) after a median of 28.5 months, and required surgical intervention. Nine patients (19.1 %) presented with tumor relapse after a median of 56.6 months (range 7.9-118.0 months). For the remaining 3...Continue Reading

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Citations

Mar 4, 2014·Seizure : the Journal of the British Epilepsy Association·Jörg WellmerJürgen Voges
Sep 1, 2015·Journal of Neurosurgery·Maximilian I RugeHarald Treuer
Jul 10, 2016·HNO·D RueßM I Ruge

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