Universität zu Köln

Ruge, Maximilian I., Simon, Thorsten, Suchorska, Bogdana, Lehrke, Ralph, Hamisch, Christina, Koerber, Friederike, Maarouf, Mohammad, Treuer, Harald, Berthold, Frank, Sturm, Volker and Voges, Juergen (2011). Stereotactic Brachytherapy With Iodine-125 Seeds for the Treatment of Inoperable Low-Grade Gliomas in Children: Long-Term Outcome. J. Clin. Oncol., 29 (31). S. 4151 - 4160. ALEXANDRIA: AMER SOC CLINICAL ONCOLOGY. ISSN 1527-7755

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Abstract

Purpose Resection is generally considered the gold standard for treatment of low-grade (WHO grades I and II) gliomas (LGGs) in childhood. However, approximately 30% to 50% of these tumors are inoperable because of their localization in highly eloquent brain areas. A few reports have suggested stereotactic brachytherapy (SBT) with implantation of iodine-125 (I-125) seeds as a safe and effective local treatment alternative. This single-center study provides a summary of the long-term outcome after SBT in one of the largest reported patient series. Patients and Methods All pediatric patients treated with SBT (I-125 seeds; cumulative therapeutic dose 50-65 Gy within 9 months) by our group for LGG with follow-up of more than 6 months were included. Clinical and radiologic outcome, time to progression, and overall survival were evaluated. Prognostic factors (age, sex, Karnofsky performance score, tumor volume, and histology) for survival and disease progression were investigated. Results In all, 147 of 160 pediatric patients treated with SBT (from 1982 through 2009) were analyzed in detail. Procedure-related mortality was zero, and the 30-day morbidity was transient and low (5.4%). Survival rates at 5 and 10 years were 93%, and 82%, respectively, with no significant difference between WHO grades I and II tumors (median follow-up, 67.1 +/- 57.7 months). Twenty-one (14.8%) of 147 patients presented with tumor relapse. The remaining 126 patients revealed complete response in 24.6%, partial response in 31.0%, and stable disease in 29.6%. Neurologic status improved (57.8%) or remained stable (23.0%). None of the evaluated factors had significant impact on the study's end points except tumor volume more than 15 mL, which caused significantly higher rates of tumor recurrence (P < .05). Conclusion We demonstrate that SBT represents a safe, minimally invasive, and highly effective local treatment option for pediatric patients with inoperable LGG WHO grades I and II. J Clin Oncol 29:4151-4159. (C) 2011 by American Society of Clinical Oncology

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ruge, Maximilian I. UNSPECIFIED UNSPECIFIED UNSPECIFIED Simon, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Suchorska, Bogdana UNSPECIFIED UNSPECIFIED UNSPECIFIED Lehrke, Ralph UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamisch, Christina UNSPECIFIED UNSPECIFIED UNSPECIFIED Koerber, Friederike UNSPECIFIED UNSPECIFIED UNSPECIFIED Maarouf, Mohammad UNSPECIFIED UNSPECIFIED UNSPECIFIED Treuer, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Berthold, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Sturm, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Voges, Juergen UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-486239
DOI:	10.1200/JCO.2011.37.3381
Journal or Publication Title:	J. Clin. Oncol.
Volume:	29
Number:	31
Page Range:	S. 4151 - 4160
Date:	2011
Publisher:	AMER SOC CLINICAL ONCOLOGY
Place of Publication:	ALEXANDRIA
ISSN:	1527-7755
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PHASE-II TRIAL; CONFORMAL RADIATION-THERAPY; OF-PEDIATRIC-ONCOLOGY; OPTIC PATHWAY TUMORS; INTERSTITIAL IRRADIATION; FUTURE STRATEGIES; CEREBRAL GLIOMAS; IMPLANTED I-125; CHIASM GLIOMAS; CHEMOTHERAPY Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/48623