Stereotactic endocavitary treatment of cysts and pseudocysts of glioma. Preliminary report.
The present study reports the results of the stereotactic treatment via endocavitary irradiation (Talaraich's method) of 50 gliomatous cysts (volume: 5-242 cm3; av.: 73 cm3) in 45 patients (M: 24; F: 21; age 3.5-57 yrs; av.: 22 yrs) in the period January 1973-January 1987. Twenty-four patients (27 cysts) were affected by a grade I glioma, 10 patients (12 cysts) by a grade II and 11 patients (11 cysts) by a grade III or IV glioma. The first step in the treatment was a neuroradiological stereotactic stereoscopical survey (tele-angiography, ventriculography, cystography) with serial biopsies and a cystic impermeability test (injection of 0.3-1 mCi of Re 186). One week later one therapeutic dose, ranging between 5 and 85 mCi of a beta-emitting colloidal radioisotope (Re 186, Au 198, Y 90), was stereotactically injected into the cyst. The stereotactic treatment was not followed by severe side effects. In high grade gliomas (grade III and IV) the benefit of the possible shrinkage and/or disappearance of the cyst was vanished by the solid tumor progression. In low grade gliomas (grade I and II) more than 50% of the cysts disappeared and 25% of them shrinked up to one third of the starting volume (follow-up: 5-168 mo.; av.: 54 mo.). At present almost only Re 186 is employed using a cyst wall dose of 400-500 Gys. The low surgical invasiveness, the absence of severe side effects and good therapeutical results induce us to propose this as a first choice treatment in inoperable low grade gliomatous expanding cysts.
Musolino
A
A
Service de Neurochirurgie, Hôpital Sainte-Anne, Paris, France.
Merckaert
P
P
Munari
C
C
Daumas-Duport
C
C
Chodkiewicz
J P
JP
D000293:Adolescent; D000328:Adult; D001918:Brachytherapy; D001932:Brain Neoplasms / Q000532:radiotherapy*; D002648:Child; D002675:Child, Preschool; D003102:Colloids; D005069:Evaluation Studies as Topic; D005260:Female; D005910:Glioma / Q000532:radiotherapy*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D013238:Stereotaxic Techniques
D003102:Colloids