Universität zu Köln

Ruge, Maximilian I., Kickingereder, Philipp, Grau, Stefan, Dorn, Franziska ORCID: 0000-0001-9093-8307, Galldiks, Norbert ORCID: 0000-0002-2485-1796, Treuer, Harald and Sturm, Volker (2013). Stereotactic iodine-125 brachytherapy for the treatment of WHO grades II and III gliomas located in the central sulcus region. Neuro-Oncology, 15 (12). S. 1721 - 1732. CARY: OXFORD UNIV PRESS INC. ISSN 1523-5866

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Abstract

Resection of gliomas located in eloquent brain areas remains a neurosurgical challenge. The reported incidence of transient or permanent neurological deficits after microsurgery in eloquent brain ranges 20100, or 047 among contemporary neurosurgical series. The aim of this study was to assess the feasibility of stereotactic brachytherapy (SBT) as a local treatment alternative to microsurgical resection for patients with gliomas in highly eloquent areas, located in the central sulcus region (CSR). Between 1997 and 2010, 60 patients with World Health Organization (WHO) grades II and III gliomas located in the CSR were treated with SBT (iodine-125 seeds; cumulative therapeutic dose, 5065 Gy). Following SBT, WHO grade III glioma patients additionally received percutaneous radiotherapy (median boost dose, 25.2 Gy). We evaluated procedure-related complications, clinical outcome, and progression-free survival. Procedure-related mortality was zero. Within 30 days of SBT, 3 patients (5) had transient neurological deficits, and 8 patients (13) had temporarily increased seizure activity. One patient (1.6) deteriorated permanently. Space-occupying cysts (6 patients) and radiation necrosis (1 patient) developed after a median of 38 months and required surgical intervention. Seizure activity, rated 12 months following SBT, decreased in 82 of patients (Engel classes IIII). Median progression-free survivals were 62.2 19.7 months (grade II gliomas) and 26.1 17.9 months (grade III gliomas). Compared with microsurgical resection, SBT harbors a low risk of procedural complications, is minimally invasive, and seems to be an effective local treatment option for patients with inoperable, eloquent WHO grade II and III gliomas in the CSR. However, the value of SBT for treating gliomas still needs to be determined in prospective, randomized studies.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ruge, Maximilian I. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kickingereder, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Grau, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Dorn, Franziska UNSPECIFIED orcid.org/0000-0001-9093-8307 UNSPECIFIED Galldiks, Norbert UNSPECIFIED orcid.org/0000-0002-2485-1796 UNSPECIFIED Treuer, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Sturm, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-471581
DOI:	10.1093/neuonc/not126
Journal or Publication Title:	Neuro-Oncology
Volume:	15
Number:	12
Page Range:	S. 1721 - 1732
Date:	2013
Publisher:	OXFORD UNIV PRESS INC
Place of Publication:	CARY
ISSN:	1523-5866
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TERM-FOLLOW-UP; SURGICAL RESECTION; BRAIN-TUMORS; FUNCTIONAL RECOVERY; RADIATION-THERAPY; RANDOMIZED-TRIAL; CEREBRAL GLIOMA; ELOQUENT BRAIN; RADIOTHERAPY; STIMULATION Multiple languages Oncology; Clinical Neurology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/47158