gms | German Medical Science

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

Stereotactic 125Iodine brachytherapy for the treatment of singular cerebral metastases – Closing the gap?

Meeting Abstract

  • Maximilian I. Ruge - Abteilung für Stereotaktische and Funktionelle Neurochirurgie, Universität Köln, Deutschland
  • Bogdana Suchorska - Abteilung für Stereotaktische Neurochirurgie, Universität Magdeburg, Deutschland
  • Mohammad Maarouf - Abteilung für Stereotaktische and Funktionelle Neurochirurgie, Universität Köln, Deutschland
  • Matthias Runge - Abteilung für Stereotaktische and Funktionelle Neurochirurgie, Universität Köln, Deutschland
  • Harald Treuer - Abteilung für Stereotaktische and Funktionelle Neurochirurgie, Universität Köln, Deutschland
  • Jürgen Voges. - Abteilung für Stereotaktische Neurochirurgie, Universität Magdeburg, Deutschland
  • Volker Sturm - Abteilung für Stereotaktische and Funktionelle Neurochirurgie, Universität Köln, 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. DocP1700

DOI: 10.3205/10dgnc171, URN: urn:nbn:de:0183-10dgnc1714

Published: September 16, 2010

© 2010 Ruge 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: To report ont stereotactic 125Iodine brachytherapy (SBT) for the treatment of singular cerebral metastases regarding feasibility, survival and cerebral disease control, in order to identify prognostic factors and to compare results with other local treatment methods.

Methods: Complications, survival (overall and separated by recursive partitioning analysis (RPA) classes), local and distant disease control were evaluated retrospectively in 90 patients. Prognostic factors were identified by forming subgroups of patients: age, KPS, status of extracranial disease, interval between initial diagnosis, absence/presence of prior whole brain radiation therapy (WBRT), localization, morphology and tumor volume.

Results: Median survival was 8.5 months for all and 18.1 months for RPA class 1 patienst, respectively. There was no treatment-related mortality and morbidity was transient and low (3.3%). After a period of one year, local recurrence was found in 3.6% and new distant cerebral disease in 46.4%. KPS≥70 (p<0.002), stable systemic disease (p<0.02), RPA class 1 (p<0.02) and a prolonged (<12months) interval between initial diagnosis and SBT improved survival significantly. There was no significant influence of previous WBRT on survival or cerebral disease recurrence.

Conclusions: SBT represents a safe, minimal invasive local treatment option which is equally effective regarding survival and cerebral disease control in comparison to SRS and microsurgery. It allows histological (re)-evaluation and treatment within one stereotactic operation. Since it is less restricted by tumor localization or size, it is an important step forward in the local treatment options and based on its favorable biological irradiation effect, SBT does not narrow additional irradiation treatment in case of disease recurrence.