PURPOSE: To assess the efficacy of interstitial brachytherapy in the treatment of patients with recurrent malignant astrocytoma. METHODS AND MATERIALS: Forty-six patients with recurrent malignant astrocytoma were treated with stereotactic high-activity temporary iodine-125 implants between September, 1986 and October, 1992. All patients had been initially treated for malignant astrocytoma (44) or low-grade astrocytoma (2) with surgery and external fractionated radiation. The median time between initial diagnosis and recurrence treated with brachytherapy was 12.5 months. Twenty-five patients received chemotherapy prior to brachytherapy. RESULTS: All but four patients have died; median survival time following brachytherapy is 46 weeks. Twelve patients underwent reoperation for radiation necrosis at a median interval of 6.5 months after treatment (26%). Five patients incurred complications directly due to brachytherapy (11%). Forty-four patients are evaluable regarding pattern of failure following brachytherapy. Six of these 44 patients (13.6%) recurred at a distance from the treatment volume (4 in brain and 2 in spinal subarachnoid space). CONCLUSION: Brachytherapy confers modest but meaningful prolongation of survival in selected patients with recurrent malignant astrocytoma, but complications are significant, reoperation frequently required, and recurrence outside the treatment volume common.
PURPOSE: To assess the efficacy of interstitial brachytherapy in the treatment of patients with recurrent malignant astrocytoma. METHODS AND MATERIALS: Forty-six patients with recurrent malignant astrocytoma were treated with stereotactic high-activity temporary iodine-125 implants between September, 1986 and October, 1992. All patients had been initially treated for malignant astrocytoma (44) or low-grade astrocytoma (2) with surgery and external fractionated radiation. The median time between initial diagnosis and recurrence treated with brachytherapy was 12.5 months. Twenty-five patients received chemotherapy prior to brachytherapy. RESULTS: All but four patients have died; median survival time following brachytherapy is 46 weeks. Twelve patients underwent reoperation for radiation necrosis at a median interval of 6.5 months after treatment (26%). Five patients incurred complications directly due to brachytherapy (11%). Forty-four patients are evaluable regarding pattern of failure following brachytherapy. Six of these 44 patients (13.6%) recurred at a distance from the treatment volume (4 in brain and 2 in spinal subarachnoid space). CONCLUSION: Brachytherapy confers modest but meaningful prolongation of survival in selected patients with recurrent malignant astrocytoma, but complications are significant, reoperation frequently required, and recurrence outside the treatment volume common.
Authors: Shannon E Fogh; David W Andrews; Jon Glass; Walter Curran; Charles Glass; Colin Champ; James J Evans; Terry Hyslop; Edward Pequignot; Beverly Downes; Eileen Comber; Mitchell Maltenfort; Adam P Dicker; Maria Werner-Wasik Journal: J Clin Oncol Date: 2010-05-17 Impact factor: 44.544
Authors: Jiri Bartek; Ali A Alattar; Sanjay Dhawan; Jun Ma; Tomoyuki Koga; Peter Nakaji; Kathryn E Dusenbery; Clark C Chen Journal: J Neurooncol Date: 2019-08-30 Impact factor: 4.130
Authors: M W McDermott; M S Berger; Sandeep Kunwar; Andrew T Parsa; P K Sneed; David A Larson Journal: J Neurooncol Date: 2004 Aug-Sep Impact factor: 4.130
Authors: Martin J van den Bent; Michael A Vogelbaum; Patrick Y Wen; David R Macdonald; Susan M Chang Journal: J Clin Oncol Date: 2009-05-18 Impact factor: 44.544