gms | German Medical Science

62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

Methodical aspects of magnetic nanoparticle induced thermotherapy of glioblastoma recurrences on the basis of phase II data

Meeting Abstract

  • H. Niehoff - Klinik für Neurochirurgie, Helios Klinikum Krefeld
  • P. Wust - Klinik für Radiotherapie, Charité - Universitätsmedizin Berlin
  • D. Nestler - Abteilung für Neurochirurgie, Bundeswehrkrankenhaus Berlin
  • F. Ulrich - Klinik für Neurochirurgie, Helios Klinikum Krefeld
  • V. Budach - Klinik für Radiotherapie, Charité - Universitätsmedizin Berlin
  • K.M. Maier-Hauff - Abteilung für Neurochirurgie, Bundeswehrkrankenhaus Berlin

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocDI.03.06

DOI: 10.3205/11dgnc119, URN: urn:nbn:de:0183-11dgnc1193

Published: April 28, 2011

© 2011 Niehoff et al.
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Outline

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Objective: Efficacy enhancement of re-irradiation of glioblastoma recurrences by nanoparticle induced local thermotherapy seems to be a promising treatment option for patients with recurrent malignant glioma. The sensitizing effect of heat in treating cancer with chemo- and radiotherapy has been known for decades and many of the corresponding molecular mechanisms are understood. Positive results of randomized trials could establish hyperthermia in combination with radio-/chemotherapy as a novel clinical modality for the treatment of cancer. Hence, based on this information a methodological appraisal should result in future trial concepts and treatment recommendations.

Methods: 59 patients with glioblastoma recurrence received fractionated stereotactic radiotherapy with a median dose of 30 Gy in a median fractionation of 5x2 Gy/week. The median planning target volume (PTV) was 46.5 cm3. Treatment was combined with local thermotherapy consisting of neuronavigationally-controlled injection of a magnetic fluid directly into the tumor and their subsequent heating in an alternating magnetic field. The magnetic fluid consists of superparamagnetic iron-oxide nanoparticles (iron concentration 112 mg/ml) with a mean diameter of 12 nm and an aminosilane type shell.

Results: Median overall survival after diagnosis of first tumor recurrence was 13.4 months (95% CI: 10.6–16.2 months) for all patients, 13.9 months (95% CI: 10.9–16.8) for those who had prior treatment following the first tumor recurrence (n=24) and 11.2 months (95% CI: 6.7–15.6) for those who had not (n=35). Median survival after primary tumor diagnosis for all patients was 23.2 months (95% CI 17.2–29.2 months). The most common acute side effects of the thermotherapy were rise of body temperature, sweating, seizures, and motor disturbances. No serious complications were observed.

Conclusions: Re-irradiation in conjunction with magnetic nanoparticle induced thermotherapy is a feasible and effective treatment for recurrent glioblastoma. The very promising data generated in this study are the basis for further treatment protocols regarding the use of thermotherapy as part of multimodal treatment concepts for brain tumors.