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

The growth pattern of recurrent glioblastoma after Gliadel® Wafer implantation in first recurrences

Meeting Abstract

  • Patrick Weigel - Klinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus der Technischen Universität, Dresden, Deutschland
  • Dino Podlesek - Klinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus der Technischen Universität, Dresden, Deutschland
  • Gabriele Schackert - Klinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus der Technischen Universität, Dresden, Deutschland
  • Dietmar Krex - Klinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus der Technischen Universität, Dresden, 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. DocP1704

DOI: 10.3205/10dgnc175, URN: urn:nbn:de:0183-10dgnc1758

Published: September 16, 2010

© 2010 Weigel 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

Text

Objective: Although in recent years, several approaches for local therapies in the treatment of glioblastoma multiforme have been tested in clinical trials, carmustin polymeres (Gliadel® Wafer) is the only evaluated local therapy to date. Because of the predominance of temozolomide, Gliadel® is frequently used in recurrent gliomas only. However, data about effectivity and the pattern of re-recurrences are rare. Therefore, we initiated the present MRI-based retrospective study.

Methods: 37 patients had surgery for first recurrence of glioblastoma, where Gliadel® Wafers (n=1–8) were implanted. Early post-op MRI was performed documenting the extent of resection, tumor remnants and wafer placements. Follow-up MRI was performed every two months looking particularly for tumor growth in relation to the wafer placements. Progression-free and overall survivals were recorded.

Results: 27 patients were available for evaluation, while 10 patients had incomplete data. In 24 (88%) patients an early tumor growth was recorded in the first MRI follow-up, 2 months post-op in areas where the wafers were not implanted. If the wafers had been placed in areas with suspicious tumor according to the early post-op MRI, tumor progression was recorded in the follow-up in 10 (67%) of 15 patients. If the wafers were placed in areas without suspicious tumor remnants (12 patients), regrowth in those areas was recorded only in 4 (33%) patients, meaning 67% of the patients had no early tumor progression when Gliadel® was placed in tumor-free areas. However, tumor pseudo-progression has to be taken into account for all cases. Survival data will be determined.

Conclusions: The use of Gliadel® Wafer in recurrent glioblastoma is most effective in areas with no tumor remnants, underlining the importance of surgical resection also of recurrent tumors.