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ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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3/2019
vol. 11
 
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abstract:
Original paper

Interstitial high-dose-rate brachytherapy in the primary treatment of inoperable glioblastoma multiforme

Georgios Chatzikonstantinou
1
,
Peter Ulrich
2
,
Eleftherios Archavlis
3
,
Nikolaos Zamboglou
1, 4
,
Iosif Strouthos
4
,
Eleni Zoga
5
,
Dimos Baltas
6, 7
,
Nikolaos Tselis
1

  1. Department of Radiotherapy and Oncology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany,
  2. Krankenhaus Nordwest, Department of Orthopaedic and Spine Surgery, Section Neurosurgery, Frankfurt am Main, Germany,
  3. Department of Neurosurgery, University Hospital Mainz, Johannes Gutenberg University, Mainz, Germany,
  4. German Oncology Center, Limassol, Cyprus,
  5. Department of Radiation Oncology, Offenbach Hospital, Offenbach am Main, Germany,
  6. Division of Medical Physics, Department of Radiation Oncology, Medical Center, Faculty of Medicine, University of Freiburg, Germany,
  7. German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (DKFZ), Heidelberg, Germany
J Contemp Brachytherapy 2019; 11, 3: 215–220
DOI: https://doi.org/10.5114/jcb.2019.85722
Online publish date: 2019/06/03
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Purpose
To report our results of image-guided interstitial (IRT) high-dose-rate (HDR) brachytherapy (BRT) in the primary treatment of patients with inoperable glioblastoma multiforme (GBM) in the pre-temozolomide period.

Material and methods
Between 1994 and 2004, 17 patients were treated with HDR BRT for inoperable GBM. Of those, only 11 patients were treated with IRT BRT, and the remaining six patients received combined IRT BRT and external beam radiotherapy (EBRT). Patient’s median age was 59.3 years (range, 29-83 years) and median tumor volume was 39.3 cm3 (range, 2-162 cm3). The prescribed HDR dose was median 40 Gy (range, 30-40 Gy), delivered twice daily in 5.0 Gy fractions over four consecutive days. Survival from BRT, toxicity as well as the impact of several prognostic factors was evaluated.

Results
At a median follow-up of 9.3 months, the median overall survival for the whole population, after BRT alone, and combined BRT with EBRT was 9.3, 7.3, and 10.1 months, respectively. Of the prognostic variables evaluated in univariate analysis, i.e., age, Karnofsky performance score, BRT dose, and tumor volume, only the latter one reached statistical significance. Two patients (11.7%) developed treatment-associated adverse events, with one (5.8%) symptomatic radionecrosis and one (5.8%) severe convulsion episode, respectively.

Conclusions
For patients with inoperable GBM, IRT HDR BRT alone or in combination with EBRT is a safe and effective irradiation method providing palliation without excessive toxicity.

keywords:

inoperable glioblastoma multiforme, high-dose-rate brachytherapy, external beam radiotherapy, combined irradiation, overall survival

  
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