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59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

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Employ of Photon Radiosurgery System (PRS) for the treatment of glioblastomas recurrent after microsurgical removal and external radiotherapy

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  • corresponding author L. Volpin - Ospedale San Bortolo, U.O. Neurochirurgia, Vicenza, Italy
  • U. Fornezza - Ospedale San Bortolo, U.O. Neurochirurgia, Vicenza, Italy
  • M. Zanusso - Ospedale San Bortolo, U.O. Neurochirurgia, Vicenza, Italy
  • F. Colombo - Ospedale San Bortolo, U.O. Neurochirurgia, Vicenza, Italy
  • L. Casentini - Ospedale San Bortolo, U.O. Neurochirurgia, Vicenza, Italy
  • G. Zambon - Ospedale San Bortolo, U.O. Neurochirurgia, Vicenza, Italy

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocP 072

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2008/08dgnc340.shtml

Published: May 30, 2008

© 2008 Volpin et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Intra-operative radiation therapy (IORT) refers to the delivery of single dose irradiation to a surgically exposed tumor at the time of the operation. The PRS employs a miniature x-ray generator which produces a radiation field similar to that of a low-energy brachyterapy source but with a delivery speed typical of external-beam radiosurgery. The aim of IORT is to sterilized malignant cells in the tumor bed, the main source of post-operative recurrence leading to treatment failure.

The aim of this study is to verify the useful of IORT for the treatment of glioblastomas (GBM) recurrences.

Methods: Since march 1999 54 patients were treated by IORT (glioma grade II, III, IV, metastases, malignant meningiomas). 21 patients (median age, 46,5 years; range, 22 to 69 years) were affected by GBM recurrent after microsurgical removal and external radiotherapy. A Karnofsky index >70 was a pre-requisite.

IORT was possible inserting the probe of miniature x-ray source into spherical applicators with diameters ranging from 1,5 to 5 cm. Doses from 8 to 15 Gy at 5 mm depth from the tumor bed were delivered after tumor removal. Delivery of the prescribe dose takes typically 10 to 45 minutes.

Follow-up >6 month was obtained in 18 patients.

Results: The median survival in 15 patients was 9,7 months (from 3 to 19 months). 3 patients are alive respectively 18, 13 and 7 months after the treatment. 1 year survival rate was 50% in 18 patients treated. 2 patients presented brain edema with a good recovery after steroid therapy. No infections were observed.

Conclusions: These preliminary results demonstrate that IORT is an effective adjuvant treatment of GBM recurrence after microsurgical removal.