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61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010
Joint Meeting mit der Brasilianischen Gesellschaft für Neurochirurgie am 20. September 2010

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21. - 25.09.2010, Mannheim

The growth pattern of recurrent glioblastoma after Gliadel® Wafer implantation in first recurrences

Meeting Abstract

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  • Patrick Weigel - Klinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus der Technischen Universität, Dresden, Deutschland
  • Dino Podlesek - Klinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus der Technischen Universität, Dresden, Deutschland
  • Gabriele Schackert - Klinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus der Technischen Universität, Dresden, Deutschland
  • Dietmar Krex - Klinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus der Technischen Universität, Dresden, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocP1704

DOI: 10.3205/10dgnc175, URN: urn:nbn:de:0183-10dgnc1758

Veröffentlicht: 16. September 2010

© 2010 Weigel et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Objective: Although in recent years, several approaches for local therapies in the treatment of glioblastoma multiforme have been tested in clinical trials, carmustin polymeres (Gliadel® Wafer) is the only evaluated local therapy to date. Because of the predominance of temozolomide, Gliadel® is frequently used in recurrent gliomas only. However, data about effectivity and the pattern of re-recurrences are rare. Therefore, we initiated the present MRI-based retrospective study.

Methods: 37 patients had surgery for first recurrence of glioblastoma, where Gliadel® Wafers (n=1–8) were implanted. Early post-op MRI was performed documenting the extent of resection, tumor remnants and wafer placements. Follow-up MRI was performed every two months looking particularly for tumor growth in relation to the wafer placements. Progression-free and overall survivals were recorded.

Results: 27 patients were available for evaluation, while 10 patients had incomplete data. In 24 (88%) patients an early tumor growth was recorded in the first MRI follow-up, 2 months post-op in areas where the wafers were not implanted. If the wafers had been placed in areas with suspicious tumor according to the early post-op MRI, tumor progression was recorded in the follow-up in 10 (67%) of 15 patients. If the wafers were placed in areas without suspicious tumor remnants (12 patients), regrowth in those areas was recorded only in 4 (33%) patients, meaning 67% of the patients had no early tumor progression when Gliadel® was placed in tumor-free areas. However, tumor pseudo-progression has to be taken into account for all cases. Survival data will be determined.

Conclusions: The use of Gliadel® Wafer in recurrent glioblastoma is most effective in areas with no tumor remnants, underlining the importance of surgical resection also of recurrent tumors.