Permanent 125iodine implants for recurrent malignant gliomas.
OBJECTIVE
To determine the efficacy and toxicity of permanent 125iodine implants for recurrent malignant gliomas.


METHODS
Between January 1989 and January:, 59 patients with histologically confirmed recurrent malignant gliomas (22 nonglioblastoma malignant gliomas, 37 glioblastoma multiforme at the time of implant) received a permanent 125iodine implant. Patients ranged in age from 13-74 years. The median ages for the overall group, nonglioblastoma (nonGBM), and glioblastoma (GBM) groups was 47 years, 39 years, and 53 years, respectively.


RESULTS
With a median follow-up of 40 months, the median survival for the 59 total patients is 1.34 years; nonGBM 2.04 years, GBM 0.9 years. Factors predictive for poor prognosis were GBM histology, age 60 years or more, target volume 17 cc or more, and/or tumor location within the corpus callosum or thalamus. Reoperations have been performed in 24 (40%) patients; 15 (25%) for tumor progression; 3 (5%) for radiation necrosis; 2 (3%) for skull necrosis/infection, and 4 (7%) for other reasons (Ommaya reservoir insertion, catheter removal, hematoma evacuation).


CONCLUSIONS
Permanent 125iodine implants in selected patients with recurrent malignant gliomas are associated with reasonable long-term survival and a low risk of complications. Given the low incidence of radiation necrosis, future plans are to increase dose rate and/or total dose delivered with the permanent implant.
Gaspar
L E
LE
Department of Radiation Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA. gasparl@karmanos.org
Zamorano
L J
LJ
Shamsa
F
F
Fontanesi
J
J
Ezzell
G E
GE
Yakar
D A
DA
D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000532:radiotherapy*; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D016019:Survival Analysis
D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals