Permanent iodine 125 brachytherapy in patients with progressive or recurrent glioblastoma multiforme

Larson, David A.; Suplica, Jeffrey M.; Chang, Susan M.; Lamborn, Kathleen R.; McDermott, Michael W.; Sneed, Penny K.; Prados, Michael D.; Wara, William M.; Nicholas, M. Kelly; Berger, Mitchel S.
April 2004
Neuro-Oncology;Apr2004, Vol. 6 Issue 2, p119
Academic Journal
This study reports the initial experience at the University of California San Francisco (UCSF) with tumor resection and permanent, low-activity iodine 125 (¹ ² ⁵I) brachytherapy in patients with progressive or recurrent glioblastoma multiforme (GM) and compares these results to those of similar patients treated previously at UCSF with temporary brachytherapy without tumor resection. Thirtyeight patients with progressive or recurrent GM were treated at UCSF with repeat craniotomy, tumor resection, and permanent, low-activity ¹ ² ⁵I brachytherapy between June 1997 and May 1998. Selection criteria were Karnofsky performance score ⩾60, unifocal, contrastenhancing, well-circumscribed progressive or recurrent GM that was judged to be completely resectable, and no evidence of leptomeningeal or subependymal spread. The median brachytherapy dose 5 mm exterior to the resection cavity was 300 Gy (range, 150–500 Gy). One patient was excluded from analysis. Median survival was 52 weeks from the date of brachytherapy. Age, Karnofsky performance score, and preimplant tumor volume were all statistically significant on univariate analyses. Multivariate analysis for survival showed only age to be significant. Median time to progression was 16 weeks. Both univariate and multivariate analysis of freedom from progression showed only preoperative tumor volume to be significant. Comparison to temporary brachytherapy patients showed no apparent difference in survival time. Chronic steroid requirements were low in patients with minimal postoperative residual tumor. We conclude that permanent ¹ ² ⁵I brachytherapy for recurrent or progressive GM is well tolerated. Survival time was comparable to that of a similar group of patients treated with temporary brachytherapy.


Related Articles

  • CT-Guided Interstitial HDR Brachytherapy for Recurrent Glioblastoma Multiforme. Gerhard Birn; Sandra Röddiger; Ineza Filipowicz; Marina Kontova; George Fountzilas; Panayiotis Selviaridis; Dimos Baltas; Reinhard Heyd; Georgios Anagnostopoulos; Nikolaos Zamboglou // Strahlentherapie und Onkologie;Oct2007, Vol. 183 Issue 10, p563 

    Background and Purpose:  Recurrences of glioblastoma multiforme (GBM) within previously irradiated volumes pose a serious therapeutic challenge. This retrospective study evaluates the long-term tumor control of recurrent GBM treated with interstitial high-dose-rate brachytherapy (HDR-BRT)....

  • Local control of high-grade gliomas with limited volume irradiation versus whole brain irradiation. Sharma, R. R.; Singh, D. P.; Pathak, A.; Khandelwal, N.; Sehgal, C. M.; Kapoor, R.; Ghoshal, S.; Patel, F. D.; Sharma, S. C. // Neurology India;Dec2003, Vol. 51 Issue 4, p512 

    Introduction: To evaluate the role of limited field radiation therapy in the management of high-grade gliomas and glioblastoma multiforme (GBM). Material and Methods: From July '96 to January '98, 50 newly diagnosed patients of high-grade gliomas (Grade III and IV) and glioblastoma multiforme...

  • Multicentric glioblastoma multiforme. Report of 3 cases, clinical and pathological study and literature review. Arcos, Andrea; Romero, Lorena; Serramito, Ramón; Santín, José M.; Prieto, Antonio; Gelabert, Miguel; Arráez, Miguel Ángel // Revista Neurocirugia;Sep/Oct2012, Vol. 23 Issue 5, p211 

    Multicentric gliomas are uncommon lesions of the central nervous system. Their management remains controversial, but histopathologic diagnosis after complete or partial resection must be performed to differentiate these tumors from other multiple cerebral lesions. Three cases of multicentric...

  • Molecular targets of glioma invasion. Nakada, M.; Nakada, S.; Demuth, T.; Tran, N. L.; Hoelzinger, D. B.; Berens, M. E. // Cellular & Molecular Life Sciences;Feb2007, Vol. 64 Issue 4, p458 

    Glioblastoma multiforme is the most common and lethal primary malignant brain tumor. Although considerable progress has been made in technical proficiencies of surgical and radiation treatment for brain tumor patients, the impact of these advances on clinical outcome has been disappointing, with...

  • An increase in CD4+CD25+FOXP3+ regulatory T cells in tumor-infiltrating lymphocytes of human glioblastoma multiforme. El Andaloussi, Abdeljabar; Lesniak, Maciej S. // Neuro-Oncology;Jul2006, Vol. 8 Issue 3, p234 

    The subpopulation of CD4+CD25+ immunoregulatory T (Tr) cells constitutes 5%-10% of CD4+ cells in humans. These cells play a crucial role in the control of tumor immune response. In this study, we evaluated the distribution of Tr cells in tumor-infiltrating lymphocytes of human glioblastoma...

  • Glioblastoma multiforme--treating a deadly tumor with both strands of RNA. Weil, Robert J. // PLoS Medicine;Jan2006, Vol. 3 Issue 1, pe31 

    The article presents information on a study on the treatment of glioblastoma multiforme (GBM). According to the article, gliomas are the most common primary tumors of the brain and at least half of all gliomas exhibit aggressive, malignant behavior. The study discusses the pathologic and...

  • Phase 2 trial of BCNU plus irinotecan in adults with malignant glioma. Reardon, David A.; Quinn, Jennifer A.; Rich, Jeremy N.; Gururangan, Sridharan; Vredenburgh, James; Sampson, John H.; Provenzale, James M.; Walker, Amy; Badruddoja, Michael; Tourt-Uhlig, Sandra; Herndon II, James E.; Dowell, Jeannette M.; Affronti, Mary Lou; Jackson, Susanne; Allen, Deborah; Ziegler, Karen; Silverman, Steven; Bohlin, Cindy; Friedman, Allan H.; Bigner, Darell D. // Neuro-Oncology;Apr2004, Vol. 6 Issue 2, p134 

    In preclinical studies, BCNU, or 1,3-bis(2-chloroethyl)-1-nitrosourea, plus CPT-11 (irinotecan) exhibits scheduledependent, synergistic activity against malignant glioma (MG). We previously established the maximum tolerated dose of CPT-11 when administered for 4 consecutive weeks in combination...

  • Phase-1 trial of gefitinib and temozolomide in patients with malignant glioma: a North American brain tumor consortium study. Prados, Michael D.; Yung, W. K. A.; Wen, Patrick Y.; Junck, Larry; Cloughesy, Timothy; Fink, Karen; Chang, Susan; Robins, H. Ian; Dancey, Janet; Kuhn, John // Cancer Chemotherapy & Pharmacology;May2008, Vol. 61 Issue 6, p1059 

    This is a phase-I study of gefitinib in combination with temozolomide in patients with gliomas. The goal of the study was to define the maximum tolerated dose (MTD) and to characterize the pharmacokinetics of gefitinib when combined with temozolomide. Patients were stratified according to...

  • Glioblastoma and Other Malignant Gliomas. Omuro, Antonio; DeAngelis, Lisa M. // JAMA: Journal of the American Medical Association;10/30/2013, Vol. 310 Issue 17, p1842 

    IMPORTANCE Glioblastomas and malignant gliomas are the most common primary malignant brain tumors, with an annual incidence of 5.26 per 100 000 population or 17 000 new diagnoses per year. These tumors are typically associated with a dismal prognosis and poor quality of life. OBJECTIVE To review...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics