[Image-fusion-guided radioisotope I-125 stereotactic brachytherapy of acoustic neurinoma--new surgical method].
Gamma knife and multi leaf collimator Linac have recently gained significant space in the treatment of acoustic neurinomas. As our neurosurgical department does not own gamma knife or Linac, we have successfully pursued the 125Iodine interstitial irradiation of three acoustic neurinomas. Our patients were elderly people with poor general condition, therefore we decided to undertake interstitial irradiation because of the low tolerance for surgery. The follow-up period until March 2002, lasted five, 23 and 40 months in the three cases. At the end of the follow-up period the audiometrical examination stated slight enhancement of hearing in case one and case two. In case one, the tumor volume, as measured on the control MRI was 5.32 cm3, which meant a 21% shrinkage in contrast to the 6.74 cm3 target volume at the brachytherapy. In case two, the shrinkage was even more apparent. The tumor volume measured on the control MRI examination was 6.64 cm3, which was a 42% shrinkage of the 11.45 cm3 target volume at the moment of brachytherapy. Due to financial reasons, gamma knife and Linac are not available for many countries and neurosurgical institutes. In the absence of the above mentioned radiosurgical methods, we have shown brachytherapy as a new alternative and solution in the treatment of acoustic neurinoma in three patients.
Viola
Arpád
A
Fóvárosi Onkormányzat, Szent János Kórház és Rendelóintézet, Idegsebészeti Osztály, Semmelweis Orvostudományi Egyetem, Doktori Iskola, Budapest. violaarpad@hotmail.com
Major
Tibor
T
Valálik
István
I
Sági
Sarolta
S
Mangel
László
L
Spellenberg
Sándor
S
Hável
János
J
Julow
Jenó
J
D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods*; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D009464:Neuroma, Acoustic / Q000532:radiotherapy* / Q000601:surgery*; D016634:Radiosurgery / Q000379:methods*; D011880:Radiotherapy Planning, Computer-Assisted; D011881:Radiotherapy, Computer-Assisted; D016896:Treatment Outcome
D007457:Iodine Radioisotopes