Stereotactic brachytherapy using iodine 125 seeds for the treatment of primary and recurrent anaplastic glioma WHO° III

• Published in: Journal of neuro-oncology Vol. 130; no. 1; pp. 123 - 131
• Main Authors: Suchorska, B., Hamisch, C., Treuer, H., Mahnkopf, K., Lehrke, R. E., Kocher, M., Ruge, M. I., Voges, J.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-10-2016
• Subjects: Adult; Brachytherapy - methods; Clinical Study; Disease-Free Survival; Female; Follow-Up Studies; Glioma - radiotherapy; Humans; Iodine Radioisotopes - therapeutic use; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Recurrence, Local - radiotherapy; Neurology; Oncology; Retrospective Studies; Statistics, Nonparametric; Treatment Outcome; World Health Organization; SBT; Anaplastic glioma; Outcome
• DOI: 10.1007/s11060-016-2214-x
• EISSN: 1573-7373
• ISSN: 0167-594X

The current study analyzed the outcome after stereotactic brachytherapy (SBT) using iodine-125 seeds in anaplastic astrocytoma, oligoastrocytoma or oligodendroglioma not suitable for resection. Out of 223 patients harbouring a malignant glioma treated according to a prospective protocol, 172 patients were selected who received SBT to treat a WHO grade III de-novo/residual tumor (n = 99) or a tumor recurrence after multimodal treatment (n = 73). We assessed progression free survival (PFS), overall survival (OS), radiological and clinical outcome and determined prognostic factors using univariate and multivariate regression analyses. The median follow-up time was 38 months. Median OS and median PFS was 28.9 and 21.4 months in the de-novo group vs. 49.4 and 32.6 months in the recurrence group. Recurrent tumors had more frequently (p = 0.01) an oligodendroglial-component compared to de novo tumors. According to cohort-specific univariate analyses KPS at SBT had a significant (p = 0.008) impact on OS in the de-novo group. In the recurrence group, (Cox regression analysis) OS was significantly associated with histology subtype (oligoastro-/oligodendroglioma vs. astrocytoma, p = 0.043). Transient and permanent morbidity (~1 %) was low. For patients unable to undergo surgery due to eloquent tumour location or reduced general condition SBT is an effective treatment option, which does not foreclose additional therapeutic interventions.