Locoregional radioimmunotherapy in selected patients with malignant glioma: experiences, side effects and survival times.
Prognosis of malignant glioma is very unfavourable mainly due to minimal tumour remnants in the peritumoural tissue. Intralesionally applied radioimmunotherapy is a possible therapeutical option with the potential to improve survival of patients with malignant glioma. We investigated side effects and survival after surgery, conventional radiotherapy and additional radioimmunotherapy with labelled tenascin-antibodies in patients with malignant glioma.


METHODS
Since 1995, 37 patients were treated with radioimmunotherapy after resection and radiotherapy of a malignant glioma. Patients received antibodies labelled with yttrium-90 and iodine-131 in different doses into the tumour cavity via a previously implanted ommaya-reservoir. Treatment was applied in up to 8 cycles (mean 2.96 cycles) in time intervals of 6-8 weeks. Mean age was 46 years, histology was anaplastic astrocytoma in 13 patients and glioblastoma in 24 patients.


RESULTS
For the whole group median survival time has not yet been reached. For glioblastoma the median survival time is 17 months, 5-year survival probability for anaplastic astrocytoma is 85% approximately. Quality of life was acceptable. Acute side effects following treatment were headache, seizures and worsening of pre-existing neurological symptoms. Late side effects were skin necrosis and, in 1 case, a delayed aphasia probably due to a vascular lesion.


CONCLUSIONS
Radioimmunotherapy prolonged survival time in a selected group of patients with malignant gliomas as compared to a historical control group. Patients with anaplastic astrocytomas seem to have more benefit from this therapy than patients with glioblastomas.
Goetz
C
C
Neurochirurgische Klinik der Ludwig-Maximilians-Universität, München, Germany. cgoetz@nc.med.uni-muenchen.de
Riva
P
P
Poepperl
G
G
Gildehaus
F J
FJ
Hischa
A
A
Tatsch
K
K
Reulen
H J
HJ
D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005910:Glioma / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D018796:Immunoconjugates; D007457:Iodine Radioisotopes; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life; D016499:Radioimmunotherapy / Q000009:adverse effects; D015996:Survival Rate; D019063:Tenascin / Q000276:immunology; D014018:Tissue Distribution; D015021:Yttrium Radioisotopes
D018796:Immunoconjugates; D007457:Iodine Radioisotopes; D019063:Tenascin; D015021:Yttrium Radioisotopes