title: Feasibility and safety of GliaSite brachytherapy in treatment of CNS tumors following neurosurgical resection.
abstract: OBJECTIVE
  To investigate feasibility and safety of GliaSite brachytherapy for treatment of central nervous system (CNS) tumors following neurosurgical resection. We report mature results of long-term follow-up, outcomes and toxicity.
  
  
  METHODS
  In the period from 2004 to 2007, 10 consecutive adult patients with recurrent, newly diagnosed, and metastatic brain malignancies underwent GliaSite brachytherapy following maximally safe neurosurgical resection. While 6/10 (60%) patients were treated for recurrence, having previously been treated with external beam radiotherapy (EBRT), 4/10 (40%) received radiotherapy (RT) for the first time. A median dose of 52.0 Gy (range, 45.0 - 60.0 Gy) was prescribed to 0.5 cm - 1.0 cm from the balloon surface. Radiation Therapy Oncology Group (RTOG) criteria were used to assess toxicities associated with this technique. Follow-up was assessed with MRI scans and was available on all enrolled patients.
  
  
  RESULTS
  Median follow-up was 38 months (range, 18 - 57 months). Mean size of GliaSite balloon was 3.4 cm (range, 2.0 - 4.0 cm). Median survival was 14.0 months for the entire cohort after the treatment. The 17.6 and 16.0 months average survival for newly diagnosed and recurrent high grade gliomas (HGG), respectively, translated into a three-month improvement in survival in patients with newly diagnosed HGG compared to historical controls (P = 0.033). There were no RTOG grades 3 or 4 acute or late toxicities. Follow-up magnetic resonance imaging (MRI) imaging did not identify radiation necrosis.
  
  
  CONCLUSIONS
  Our data indicate that treatment with GliaSite brachytherapy is feasible, safe and renders acceptable local control, acute and long-term toxicities. We are embarking on testing larger numbers of patients with this treatment modality.
authors.affiliation: Radiation Oncology, Weil Cornell University School of Medicine, New York, NY, USA.
authors.forename: A Gabriella
authors.initials: AG
authors.lastname: Wernicke
authors.forename: David L
authors.initials: DL
authors.lastname: Sherr
authors.forename: Theodore H
authors.initials: TH
authors.lastname: Schwartz
authors.forename: Susan C
authors.initials: SC
authors.lastname: Pannullo
authors.forename: Philip E
authors.initials: PE
authors.lastname: Stieg
authors.forename: John A
authors.initials: JA
authors.lastname: Boockvar
authors.forename: Jana
authors.initials: J
authors.lastname: Ivanidze
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Moliterno
authors.forename: Bhupesh
authors.initials: B
authors.lastname: Parashar
authors.forename: Samuel
authors.initials: S
authors.lastname: Trichter
authors.forename: Albert M
authors.initials: AM
authors.lastname: Sabbas
authors.forename: Dattatreyudu
authors.initials: D
authors.lastname: Nori
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D001932:Brain Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D010865:Pilot Projects; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000379:methods