Brachytherapy of glioblastoma recurring in previously irradiated territory: predictive value of tumor volume.
OBJECTIVE
To evaluate the impact of tumor volume on survival of patients reirradiated with (192)Ir for recurrent glioblastoma.


METHODS
Between 1993 and 1997, 42 patients with recurrent glioblastomas (29 males and 13 females, age 18-69 years, median age 49) were treated with (192)Ir implantation. Previous treatments included surgery, external beam radiotherapy, and chemotherapy. Maximum diameter of the recurrent tumor was 1.2-10.1 cm (median: 5.7 cm) and tumor volume was 1.6-122 cm(3) (median: 23 cm(3)). Karnofsky performance status score was 50-100 (median: 80). Brachytherapy dose was 40-60 Gy.


RESULTS
Probability of overall survival was 80% at 6 months, 48% at 1 year, and 11% at 2 years. Median survival was 50 weeks. Univariate analysis showed that both tumor volume (T < or T > or = 30 cm(3)) and Karnofsky performance status score were significant predictors of survival. Multivariate analysis showed that smaller tumor volumes were associated with a higher probability of survival (p < 0.001).


CONCLUSIONS
Tumor volume less than 30 cm(3) was associated with a higher probability of, and quality of, survival than larger lesions for patients reirradiated by brachytherapy for recurrent glioblastoma.
Simon
Jean Marc
JM
Department of Radiation Oncology, Hôpital de la Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, 47/83 Boulevard de l'Hôpital, 75651 Paris cedex 13, France. jean-marc.simon@psl.ap-hop-paris.fr
Cornu
Philippe
P
Boisserie
Gilbert
G
Hasboun
Dominique
D
Tep
Bernadette
B
Hardiman
Claire
C
Valery
Charles A
CA
Delattre
Jean Yves
JY
Dormont
Didier
D
Baillet
François
F
Mazeron
Jean Jacques
JJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001918:Brachytherapy / Q000009:adverse effects; D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005909:Glioblastoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D007496:Iridium Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D011379:Prognosis; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D015173:Supratentorial Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D016019:Survival Analysis
D007496:Iridium Radioisotopes