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62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

07. - 11. Mai 2011, Hamburg

Stereotactic brachytherapy with 125Iodine seeds (SBT) for the treatment of WHO Grade II and III gliomas located in the central sulcus

Meeting Abstract

  • M.I. Ruge - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Klinikum der Universität zu Köln
  • M. Fuetsch - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Klinikum der Universität zu Köln
  • S. Grau - Zentrum für Neurochirurgie, Klinikum der Universität zu Köln
  • P. Kickingereder - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Klinikum der Universität zu Köln
  • C. Hamisch - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Klinikum der Universität zu Köln
  • H. Treuer - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Klinikum der Universität zu Köln
  • J. Voges - Klinik für Stereotaktische Neurochirurgie, Universitätsklinikum Magdeburg
  • V. Sturm - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Klinikum der Universität zu Köln

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocMI.03.07

DOI: 10.3205/11dgnc194, URN: urn:nbn:de:0183-11dgnc1947

Veröffentlicht: 28. April 2011

© 2011 Ruge 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: Despite advances in preoperative (functional) imaging and the use of intraoperative guidance and mapping techniques, gliomas located in the area of the central sulcus are still a big challenge for resective surgery due to a high risk of severe neurological deficits. Stereotactic brachytherapy (SBT) after implantation of 125Iodine seeds has been reported to be a minimally invasive, safe and effective treatment alternative to resection, especially for small tumours located in eloquent brain areas. With the present retrospective analysis, we determined the value of SBT for the therapy of gliomas infiltrating the area of the pre- or post-central sulcus.

Methods: Almost 500 patients underwent SBT (125Iodine seeds, surface dose 50Gy, permanent implantation) for supratentorial WHO° II and III gliomas in our institution from 1997 through 2010. For this retrospective analysis, we selected those patients with circumscribed tumours (<4 cm diameter) located within the area of the central sulcus. For patients with WHO°III gliomas receiving SBT as first-line therapy, adjuvant percutaneous radiotherapy (boost-dose: 15-30 Gy) was added. We evaluated procedure-related complications in the early postoperative period and in the long-term run, as well as time to tumour progression stratified by WHO grade. For statistical analysis, Kaplan-Meier estimates and the Log-rank test were used.

Results: Sixty patients (WHO°II: 29 patients; WHO°III: 31 patients) fulfilled the selection criteria. There was no procedure-related mortality. Within 30-days after seed implantation 3/60 patients (5%) had transient neurological deficits and 6/60 patients (10%) had temporarily increased seizure activity improving in all cases after adaptation of the anticonvulsive medication. After a median of 66.6 months (range, 39-114 months), three patients (5.0%) developed space-occupying cysts requiring surgical intervention. The median time to tumour progression was 53.6 months for WHO°II and 26.2 months for WHO°III gliomas.

Conclusions: Compared to neurosurgical resection, SBT is a safe and minimal invasive treatment option with a low rate of transient complications for patients with circumscribed WHO grade II and III gliomas located in the area of the central sulcus. The achieved tumour control is well comparable with results after resection.