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

Intracranial ependymoma: Long-term results in a series of 21 patients treated with stereotactic 125Iodine brachytherapy

Meeting Abstract

  • F.E. Majdoub - Klinik für Stereotaktische und Funktionelle Neurochirurgie, Klinikum der Universität zu Köln
  • T. Blau - Institut für Neuropathologie, Klinikum der Universität zu Köln
  • M. Hoevels - Klinik für Stereotaktische und Funktionelle Neurochirurgie, Klinikum der Universität zu Köln
  • V. Sturm - Klinik für Stereotaktische und Funktionelle Neurochirurgie, Klinikum der Universität zu Köln
  • M. Maarouf - Klinik für Stereotaktische und Funktionelle 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.11.01

DOI: 10.3205/12dgnc381, URN: urn:nbn:de:0183-12dgnc3813

Published: June 4, 2012

© 2012 Majdoub et al.
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Outline

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Objective: We evaluated the long-term outcome and prognostic factors of patients harboring intracranial ependymomas treated with interstitial brachytherapy (IBT) using 125Iodine seeds.

Methods: Twenty-one patients (M/F ratio, 9/12; median age, 29 years; range, 8–70 years), diagnosed with intracranial ependymoma (1 WHO I, 11 WHO II, 9 WHO III) were treated with interstitial brachytherapy using stereotactically implanted 125Iodine seeds between 1987 and 2010, either as primary-, adjuvant therapy following incomplete resection or salvage therapy upon tumor recurrence. Sixteen of 21 patients (76.2%) underwent microsurgical resection prior to IBT; in five patients, IBT was performed primarily after stereotactic biopsy to establish histological diagnosis. The cumulative tumor surface dose ranged from 50 to 65 Gy treating a median tumor volume of 3.6 ml (range, 0.3–11.6 ml). A median follow-up period of 105.3 months (range, 10.7–286.2 months) was available.

Results: Overall actuarial 2-, 5- and 10-years survival rates after IBT were each 90% for ependymomas WHO I/II, for anaplastic ependymomas WHO III 100%, 100% and 70%, respectively. The neurological status of seven patients improved, while there was no change and deterioration in 12 and 2 patients, respectively. Follow-up MR images showed a complete tumor remission in 14.3% (3/21), a partial remission in 57.1% (12/21) and a stable disease in 28.6% (6/21) of the cases. There was no treatment-related mortality. Treatment-related morbidity occurred in a single patient resulting in an impairment of his cognitive functions.

Conclusions: Our study demonstrates that stereotactic interstitial brachytherapy for the management of intracranial ependymomas is safe and can provide high local tumor control. Due to the low rate of side effects, interstitial brachytherapy may become an attractive alternative to microsurgery in ependymomas located in eloquent areas or as salvage treatment.