[Interstitial radiosurgery of low grade glioma].
In this retrospective study the outcome of 324 patients with low-grade gliomas (WHO-Grade II) is evaluated, who from 1979 to 1991 underwent stereotactic biopsy and interstitial radiosurgery (Iodine-125). The patients were selected for interstitial radiosurgery if the tumor was unifocal, well-circumscribed and in diameter < or = 4 cm. Of these patients 251 had astrocytomas, 29 had oligodendrogliomas, and 44 had oligoastrocytomas. All patients presented with progressive neurological deficit or showed evidence of CT/MRI confirmed tumor growth. The preoperative performance status was > or = 70%. Diffusely infiltrative, non-delineated gliomas and gliomas crossing the midline were excluded. Five-year survival rates were 65% for astrocytomas, 80% for oligoastrocytomas and 58% for oligodendrogliomas. In the multivariate analysis age was a significant factor predicting survival. Patients who received temporary implants had a significantly better outcome than those with permanent implants. Radiation toxicity (3.1%) was seen mostly among the permanent implants. No patients required reoperation due to radionecrosis. The findings in this subgroup of gliomas indicate that interstitial radiosurgery using Iodine-125 is effective in controlling tumor growth and is well tolerated. Patients with differentiated and circumscribed gliomas particularly benefit from the treatment.
Kreth
F W
FW
Abteilung Stereotaktische Neurochirurgie, Neurochirurgische Universitätsklinik Freiburg.
Warnke
P C
PC
Ostertag
C B
CB
D000293:Adolescent; D000328:Adult; D001254:Astrocytoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001706:Biopsy; D001921:Brain / Q000473:pathology; D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009837:Oligodendroglioma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011788:Quality of Life; D016634:Radiosurgery; D015996:Survival Rate; D016896:Treatment Outcome
Interstitielle Radiochirurgie niedergradiger Gliome.