title: Stereotactic brachytherapy using iodine 125 seeds for the treatment of primary and recurrent anaplastic glioma WHO° III.
abstract: The current study analyzed the outcome after stereotactic brachytherapy (SBT) using iodine-125 seeds in anaplastic astrocytoma, oligoastrocytoma or oligodendroglioma not suitable for resection. Out of 223 patients harbouring a malignant glioma treated according to a prospective protocol, 172 patients were selected who received SBT to treat a WHO grade III de-novo/residual tumor (n = 99) or a tumor recurrence after multimodal treatment (n = 73). We assessed progression free survival (PFS), overall survival (OS), radiological and clinical outcome and determined prognostic factors using univariate and multivariate regression analyses. The median follow-up time was 38 months. Median OS and median PFS was 28.9 and 21.4 months in the de-novo group vs. 49.4 and 32.6 months in the recurrence group. Recurrent tumors had more frequently (p = 0.01) an oligodendroglial-component compared to de novo tumors. According to cohort-specific univariate analyses KPS at SBT had a significant (p = 0.008) impact on OS in the de-novo group. In the recurrence group, (Cox regression analysis) OS was significantly associated with histology subtype (oligoastro-/oligodendroglioma vs. astrocytoma, p = 0.043). Transient and permanent morbidity (~1 %) was low. For patients unable to undergo surgery due to eloquent tumour location or reduced general condition SBT is an effective treatment option, which does not foreclose additional therapeutic interventions.
authors.affiliation: Department of Stereotactic Neurosurgery, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany.|Department of Neurosurgery, Ludwig Maximilians University of Munich, Munich, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Suchorska
authors.affiliation: Department of Stereotaxy and Functional Neurosurgery, Centre of Neurosurgery, University of Cologne, Cologne, Germany.|Department of Neurosurgery, Centre of Neurosurgery, University of Cologne, Cologne, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Hamisch
authors.affiliation: Department of Stereotaxy and Functional Neurosurgery, Centre of Neurosurgery, University of Cologne, Cologne, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Treuer
authors.affiliation: Department of Stereotactic Neurosurgery, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Mahnkopf
authors.affiliation: Department of Stereotactic Neurosurgery, St. Barbara Hospital, Hamm, Germany.
authors.forename: R E
authors.initials: RE
authors.lastname: Lehrke
authors.affiliation: Department of Radiation Oncology, University Hospital of Cologne, Cologne, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Kocher
authors.affiliation: Department of Stereotaxy and Functional Neurosurgery, Centre of Neurosurgery, University of Cologne, Cologne, Germany.
authors.forename: M I
authors.initials: MI
authors.lastname: Ruge
authors.affiliation: Department of Stereotactic Neurosurgery, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany. juergen.voges@med.ovgu.de.|Leibniz Institute for Neurobiology, Magdeburg, Germany. juergen.voges@med.ovgu.de.
authors.forename: J
authors.initials: J
authors.lastname: Voges
mesh_terms: D000328:Adult; D001918:Brachytherapy / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000532:radiotherapy*; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014944:World Health Organization
chemical_list: D007457:Iodine Radioisotopes; C000614960:Iodine-125
keywords: Anaplastic glioma; Outcome; SBT