Universität zu Köln

Suchorska, Bogdana, Ruge, Maximilian, Treuer, Harald, Sturm, Volker and Voges, Juergen (2011). Stereotactic brachytherapy of low-grade cerebral glioma after tumor resection. Neuro-Oncology, 13 (10). S. 1133 - 1143. CARY: OXFORD UNIV PRESS INC. ISSN 1523-5866

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Abstract

The purpose of this study was to assess the impact of stereotactic brachytherapy (SBT) on survival time and outcome when applied after resection of low-grade glioma (LGG) of World Health Organization grade H. From January 1982 through December 2006 we treated 1024 patients who had glioma with stereotactic implantation of iodine-125 seeds and SBT in accordance with a prospective protocol. For the present analysis, we selected 95 of 277 patients with LGG, in whom SBT was applied to treat progressive (43 patients) or recurrent (52 patients) tumor after resection. At 24 months after seed implantation, the tumor response rate was 35.9%, and the tumor control rate was 97.3%. The median progression-free-survival (PFS) duration after SBT was 52.7 +/- 7.1 months. Five-year and 10-year PFS probabilities were 43.4% and 10.7%, respectively. Malignant tumor transformation, the diagnosis astrocytoma, and tumor volume >20 mL were significantly associated with reduced PFS. Tumor progression or relapse after SBT (53 of 95 patients) was treated with tumor resection, a second SBT, chemotherapy, and/or radiotherapy. The median overall survival duration (from the first diagnosis of LGG until the patient's last contact) was 245.0 +/- 4.9 months. Patients still under observation after seed implantation had a median follow-up time of 156.4 +/- 55.7 months. Perioperative transient morbidity was 1.1%, and the frequency of permanent morbidity caused by SBT was 3.3%. In conclusion, SBT of recurrent or progressive LGG after resection located in functionally critical brain areas has high local efficacy and comparably low morbidity. Referred to individually adopted glioma treatment concepts SBT provides a reasonably long PFS, thus improving overall survival. In selected patients, SBT can lead to delays in the application of chemotherapy and/or radiotherapy.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Suchorska, Bogdana UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruge, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Treuer, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Sturm, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Voges, Juergen UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-487812
DOI:	10.1093/neuonc/nor100
Journal or Publication Title:	Neuro-Oncology
Volume:	13
Number:	10
Page Range:	S. 1133 - 1143
Date:	2011
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 PROGNOSTIC-FACTORS; RADIATION-THERAPY; RANDOMIZED-TRIAL; I-125 BRACHYTHERAPY; REGRESSION-MODELS; ADULT PATIENTS; DOSE-RESPONSE; SUPRATENTORIAL; RADIOSURGERY; ASTROCYTOMA Multiple languages Oncology; Clinical Neurology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/48781