gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Anaplastic oligodendroglial tumors: Management with stereotactic interstitial brachytherapy

Meeting Abstract

  • F.E. Majdoub - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Zentrum für Neurochirurgie, Klinikum der Universität zu Köln
  • P. Kickingereder - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Zentrum für Neurochirurgie, Klinikum der Universität zu Köln
  • M. Hoevels - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Zentrum für Neurochirurgie, Klinikum der Universität zu Köln
  • H. Treuer - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Zentrum für Neurochirurgie, Klinikum der Universität zu Köln
  • V. Sturm - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Zentrum für Neurochirurgie, Klinikum der Universität zu Köln
  • M. Maarouf - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Zentrum für Neurochirurgie, Klinikum der Universität zu Köln

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocSA.07.09

DOI: 10.3205/12dgnc349, URN: urn:nbn:de:0183-12dgnc3491

Published: June 4, 2012

© 2012 Majdoub et al.
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Outline

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Objective: We evaluated the efficacy and safety of interstitial brachytherapy (IBT) using 125Iodine-Seeds (125I) for the treatment of anaplastic oligodendroglial brain tumors. Moreover prognostic factors were analyzed.

Methods: Between January 1991 and December 2010, 37 patients (M/F: 21/16; median age 47.9 years, range 20.8–63.4 years) suffering from anaplastic oligodendroglial brain tumors (anaplastic oligoastrocytoma III, n=17; anaplastic oligodendroglioma III, n = 20) were treated at our institution with IBT using 125I either as a primary, adjuvant after incomplete resection or as salvage therapy after tumor recurrence. The prognostic factors (age, gender, histology, grading, Karnofsky Performance Status, tumor volume, tumor surface dose, implantation time, clinical symptoms and postoperative treatments) for disease progression and survival were retrospectively investigated.

Results: Actuarial 2-, 5- and 9-years overall- and progression-free survival rates after IBT for the entire group were 77%, 62%, 51% and 68%, 44%, 22%, respectively. Follow-up MR images showed a complete remission in 1 patient, a partial remission in 7 patients, a stable disease in 10 patients and a tumor progression in 19 patients. The median time to progression was 30.9 months (range 5.2–112.5 months; median follow-up 66.6 months, range 10.4–247 months). Neurological status improved in 11 patients and remained stable in 10 patients. There was no treatment-related mortality. Treatment related morbidity within one month was transient and occurred in 4 patients only. The variables gender, tumor surface dose, Karnofsky Performance Status, histology and grading had no significant impact on overall- and progression-free survival. Age <45 years, tumor volume <20 ml, seizures as initial symptom, permanent implantation, and adjuvant external beam irradiation were significantly associated with an increased overall- and progression-free survival (p<0.05).

Conclusions: This study indicates that stereotactic interstitial brachytherapy for the management of anaplastic oligodendroglial brain tumors is effective and safe. Due to a high local tumor control and a low rate of side effects, IBT should be considered as one arm in the multimodal treatment of anaplastic oligodendroglial tumors.