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61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

Intratumoral thermotherapy using magnetic nanoparticles in combination with fractionated stereotactic radiotherapy in patients with recurrent glioblastoma multiforme

Meeting Abstract

  • Klaus Maier-Hauff - Abteilung für Neurochirurgie, Bundeswehrkrankenhaus Berlin, Deutschland
  • Hendrik Niehoff - Klinik für Neurochirurgie, Helios Klinikum Krefeld, Deutschland
  • Dirk Nestler - Abteilung für Neurochirurgie, Bundeswehrkrankenhaus Berlin, Deutschland
  • Peter Wust - Klinik für Radiotherapie, Charité – Universitätsmedizin Berlin, Deutschland
  • Volker Budach - Klinik für Radiotherapie, Charité – Universitätsmedizin Berlin, Deutschland
  • Frank Ulrich - Klinik für Neurochirurgie, Helios Klinikum Krefeld, 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. DocV1541

DOI: 10.3205/10dgnc018, URN: urn:nbn:de:0183-10dgnc0188

Published: September 16, 2010

© 2010 Maier-Hauff 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: We investigated the effectiveness of a combined treatment of fractionated stereotactic radiotherapy in conjunction with a new intratumoral thermotherapy method using magnetic nanoparticles in patients with recurrent glioblastoma with respect to toxicity and survival outcome.

Methods: In a single-arm two-centre study, 59 patients with recurrent glioblastoma received neuronavigationally-controlled intratumoral injection of an aqueous dispersion of iron-oxide nanoparticles, which were subsequently heated in an alternating magnetic field. Treatment was combined with fractionated stereotactic radiotherapy applying a median dose of 30 Gy in conventional fractionation. Median time between primary diagnosis and first tumor recurrence was 8.0 months.

Results: Median overall survival after diagnosis of first tumor recurrence (OS-2) was 13.4 months (95% CI: 10.6–16.2 months). Median survival after primary tumor diagnosis (OS-1) was 23.2 months (95% CI 17.2–29.2 months). Only tumor volume at study entry was significantly correlated with OS-2 (p<0.01). No other factors – age, KPS or time to first tumor progression – had any significant prognostic value on OS-2. The side effects of the new therapeutic approach were moderate, and no serious complications were observed. Commonest were rise of body temperature, sweating, seizures and motor disturbances. However, in less than 5% of the patients, during thermotherapy neurological disorders occurred for the first time.

Conclusions: Thermotherapy using magnetic nanoparticles in conjunction with radiotherapy is safe in treatment of recurrent glioblastoma and results in a significantly longer median survival compared to conventional treatments in historical groups.