Outcome and toxicity profile of salvage low-dose-rate iodine-125 stereotactic brachytherapy in recurrent high-grade gliomas

摘要: The aim of this study was to provide an outcome and toxicity profile salvage low-dose-rate iodine-125 (I-125) stereotactic brachytherapy (SBT) in patients with small, circumscribed malignant glioma recurrences. Patients recurrences consecutively undergoing SBT from 2003 2011 were identified our prospective tumor database. considered a potentially suitable treatment strategy for adult mostly multimodally pretreated (Karnofsky score of ≥ 70) biopsy-proven, circumscribed, small (diameter ≤ 3.5 cm) Exclusively temporary I-125 seeds used (reference dose: 50 Gy, dose rate: < 15 cGy/h). Study endpoints time-to-treatment failure (TTF) after SBT, postrecurrence survival (PRS), toxicity. Survival assessed the Kaplan–Meier method. Adverse events categorized according RTOG/EORTC classification. Prognostic factors obtained proportional hazards models. Sixty-eight (28 WHO grade III, 40 IV gliomas) included. Fifty-nine had previously received external beam radiation. Median TTF PRS 8.3 months 13.4 months, respectively. longer III gliomas than glioblastomas (15.0 vs. 6.2 months 28.1 9.3 months, respectively). tumors younger (p = 0.002). Favorable age ≤ 50 years methylated O(6)-methylguanine-DNA methyltransferase (MGMT)-promoter. Alternative models including instead age reached similar good fit. Three suffered I, one II, two Salvage is feasible safe even performed measurements particular deserve further evaluation.