gms | German Medical Science

Objective: This current study was designed to evaluate the therapeutic effect and eventual side-effects of an additional brachytherapy (Iodine 125, Gliasite^®) in patients operated for recurrent malignant gliomas.

Methods: Quality of life and outcome as well as therapeutic side-effects of an interstitial brachytherapy with Iodine 125 were prospectively evaluated in 18 patients (39–75 years, Karnofsky Score 80–100 points) with recurrent malignant gliomas (12 GBM, 3 oligodendroglioma III, 1 astrocytoma III, 1 oligoastrocytoma III, 1 gliosarcoma) in this ongoing study.

All patients were operated for their recurrent tumour at our institution. These recurrences had developed in spite of standard glioma therapy (operation, temozolomid, radiation).

Brachytherapy was applied via a specially designed system (Gliasite^®) which had been implanted during the second operation. Radiation doses varied from 30–60 G with a depth of 1–2 cm from the margin of resection. Follow-up time varied from 2–42 months.

Results: Up to now 8 of the 18 patients are still alive (6 of the 13 GBM patients). Mean survival time of all patients up to now is 205 weeks after first diagnosis and 67 weeks following brachytherapy respectively. The corresponding figures for GBM patients with at least 12 months follow-upo are 45 weeks after brachytherapy and 121 weeks following the initial diagnosis.

In general the procedure was well tolerated. Minor side-effects were 1 deep wound infection in 1 patient and disconnection of the system during explantation in another (both requiring an additional operation).

Conclusions: Interstitial radiotherapy with Iodine 125 (Gliasite^®) is an effective additional treatment with few side-effects in patients operated for recurrent malignant gliomas. In patients with malignant gliomas 17 months additional lifetime may be gained by this procedure, in GBM patients 11 months.