title: Long-term follow-up after high-activity 125I brachytherapy for pediatric brain tumors.
abstract: A retrospective review including long-term follow-up (4.6-12.0 years) was performed of all 28 pediatric patients who underwent high-activity 125I brachytherapy at the University of California, San Francisco, for primary or recurrent brain tumors from 1980 until 1991. There were 4 glioblastomas, 11 high-grade nonglioblastoma multiforme (NGM) malignant gliomas, 10 contrast-enhancing low-grade NGM, 2 choroid plexus carcinomas, and 1 rhabdomyosarcoma. The 13 survivors included 7 of 8 patients with primary high-grade NGM, 2 of 3 patients with primary low-grade NGM, and 3 of 7 patients with recurrent low-grade NGM. Necrosis (with or without tumor) was identified in 17 of 22 reoperated patients. The mean Karnofsky performance status was 88 +/- 9 at the time of brachytherapy, 87 +/- 7 at 3 years, and 87 +/- 9 in 11 patients alive at 6-12 years. Brachytherapy is a useful modality for treating selected pediatric brain tumors, and although focal necrosis is a common sequela, it does not tend to have a major impact on the Karnofsky performance status, if the implant site is amenable to reoperation.
authors.affiliation: Department of Radiation Oncology, University of California, San Francisco 94143-0226, USA.
authors.forename: P K
authors.initials: PK
authors.lastname: Sneed
authors.forename: C
authors.initials: C
authors.lastname: Russo
authors.forename: C O
authors.initials: CO
authors.lastname: Scharfen
authors.forename: M D
authors.initials: MD
authors.lastname: Prados
authors.forename: M K
authors.initials: MK
authors.lastname: Malec
authors.forename: D A
authors.initials: DA
authors.lastname: Larson
authors.forename: K R
authors.initials: KR
authors.lastname: Lamborn
authors.forename: S A
authors.initials: SA
authors.lastname: Lamb
authors.forename: B
authors.initials: B
authors.lastname: Voss
authors.forename: K A
authors.initials: KA
authors.lastname: Weaver
authors.forename: T L
authors.initials: TL
authors.lastname: Phillips
authors.forename: P H
authors.initials: PH
authors.lastname: Gutin
authors.forename: W M
authors.initials: WM
authors.lastname: Wara
authors.forename: M S
authors.initials: MS
authors.lastname: Edwards
mesh_terms: D000293:Adolescent; D001254:Astrocytoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D001918:Brachytherapy / Q000295:instrumentation*; D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005909:Glioblastoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005910:Glioma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D007223:Infant; D017567:Karnofsky Performance Status; D008297:Male; D009336:Necrosis; D009367:Neoplasm Staging; D011880:Radiotherapy Planning, Computer-Assisted / Q000295:instrumentation; D013238:Stereotaxic Techniques / Q000295:instrumentation; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000295:instrumentation