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. 2020 Dec 9;15(1):275.
doi: 10.1186/s13014-020-01719-9.

Long-term outcome of stereotactic brachytherapy with temporary Iodine-125 seeds in patients with WHO grade II gliomas

Juliana Watson  1 , Alexander Romagna  2   3 , Hendrik Ballhausen  1 , Maximilian Niyazi  1 , Stefanie Lietke  4 , Sebastian Siller  4 , Claus Belka  1   5 , Niklas Thon  4 , Silke Birgit Nachbichler  6
Affiliations

Long-term outcome of stereotactic brachytherapy with temporary Iodine-125 seeds in patients with WHO grade II gliomas

Juliana Watson et al. Radiat Oncol. .

Abstract

Background: This long-term retrospective analysis aimed to investigate the outcome and toxicity profile of stereotactic brachytherapy (SBT) in selected low-grade gliomas WHO grade II (LGGII) in a large patient series.

Methods: This analysis comprised 106 consecutive patients who received SBT with temporary Iodine-125 seeds for histologically verified LGGII at the University of Munich between March 1997 and July 2011. Investigation included clinical characteristics, technical aspects of SBT, the application of other treatments, outcome analyses including malignization rates, and prognostic factors with special focus on molecular biomarkers.

Results: For the entire study population, the 5- and 10-years overall survival (OS) rates were 79% and 62%, respectively, with a median follow-up of 115.9 months. No prognostic factors could be identified. Interstitial radiotherapy was applied in 51 cases as first-line treatment with a median number of two seeds (range 1-5), and a median total implanted activity of 21.8 mCi (range 4.2-43.4). The reference dose average was 54.0 Gy. Five- and ten-years OS and progression-free survival rates after SBT were 72% and 43%, and 40% and 23%, respectively, with a median follow-up of 86.7 months. The procedure-related mortality rate was zero, although an overall complication rate of 16% was registered. Patients with complications had a significantly larger tumor volume (p = 0.029).

Conclusion: SBT is a minimally invasive treatment modality with a favorable outcome and toxicity profile. It is both an alternative primary treatment method as well as an adjunct to open tumor resection in selected low-grade gliomas.

Keywords: Grade II glioma; Iodine-125 seeds; Low-grade glioma; Stereotactic brachytherapy.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Example for a treatment plan in a patient with grade II astrocytoma (seeds 3, volume 14.4 ml, reference dose 54 Gy, minimum dose 36 Gy, maximum dose 763 Gy, total implanted activity 31.7 mCi)
Fig. 2
Fig. 2
Overall survival (OS) and progression-free survival (PFS) after stereotactic brachytherapy (SBT) of all 106 patients
See this image and copyright information in PMC

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