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66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Friendship Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

7. - 10. Juni 2015, Karlsruhe

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Treatment of cerebral malignant lesions using I.O.R.T. with Intrabeam PRS

Meeting Abstract

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  • Mariano Agostino Zanusso - U.O. Neurochirurgia, Ospedale Civile San Bortolo Vicenza (VI)
  • Lorenzo Volpin - U.O. Neurochirurgia, Ospedale Civile San Bortolo Vicenza (VI)
  • Alessandro Segna - U.O. Neurochirurgia, Ospedale Civile San Bortolo Vicenza (VI)
  • Giampaolo P. Zambon - U.O. Neurochirurgia, Ospedale Civile San Bortolo Vicenza (VI)
  • Paolo Francescon - U.O. Fisica Sanitaria, Ospedale Civile San Bortolo Vicenza (VI)
  • D. Danieli - U.O. Anatomia Patologica, Ospedale Civile San Bortolo Vicenza (VI)
  • G. Beggio - U.O. Neurochirurgia, Ospedale Civile San Bortolo Vicenza (VI)
  • F. Volpin - U.O. Neurochirurgia, Ospedale Civile San Bortolo Vicenza (VI)
  • Federico Colombo - U.O. Neurochirurgia, Ospedale Civile San Bortolo Vicenza (VI)

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocDI.14.07

doi: 10.3205/15dgnc174, urn:nbn:de:0183-15dgnc1744

Veröffentlicht: 2. Juni 2015

© 2015 Zanusso et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: I.O.R.T. (intra-operative radiotherapy) refers to the application of radiation during a surgical intervention after the removal of the neoplastic mass, using the incision to direct a selective radiation boost to the tumor bed to the possible localization of sub-clinic illness or to macroscopic residue in the case of non-radical resection.

Method: We selected a subgroup of patients according to the following criteria: primitive malignant and secondary intracranial tumours, tumour recurrences after surgery and conventional chemo/radiotherapy, surgery feasible.

Results: 71 patients (30 F, 41 M) underwent surgery associated with IORT; the mean age of the patients was 58 yrs (range 19 - 83 yrs). We treated 58 patients affected by Primary cancer (Glioblastoma (46), Oligodendroglioma GIII (12)) and 13 patients affected by Cerebral Metastases (13 pts). The mean dose applied to the tumoral bed was 16.35 Gy. The mean survival time after the EBRT was 8,9 months (range 3-14 months). The mean postoperative KPS was 80 (range 60-90). The post operative KPS score (4 months after surgery) decreased of 10% compared with the preoperative score.

Conclusions: The aim of PRS is to sterilized malignant cells in the tumor bed, the main source of post-operative recurrence leading to treatment failure. The Intrabeam carrier is easy to handle and the irradiation is checked by the control unit during the whole treatment, in order to minimize possible dose-errors. One of the most important limitations is the volume of the applicator, requiring large craniotomies to fit the surgical cavity surface. This technique showed partial promising results, nevertheless, more information on its efficacy related to the tumoral subgroups is necessary.