Interstitial Brachytherapy using Stereotactic Implanted ¹²⁵Iodine Seeds for Recurrent Medulloblastoma

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• 作者：F.  ; El Majdoub^&lowast ; ; T.  ; Simon^&dagger ; ; M.  ; Hoevels^&lowast ; ; F.  ; Berthold^&dagger ; ; V.  ; Sturm^&lowast ; ; M.  ; Maarouf^&lowast ; ;   ; ^{m.maarouf@uni-koeln.de}
• 关键词：Interstitial brachytherapy ; ¹²⁵iodine ; medulloblastoma ; recurrence ; stereotactic
• 刊名：Clinical Oncology
• 出版年：2011
• 出版时间：October 2011
• 年：2011
• 卷：23
• 期：8
• 页码：532-537
• 全文大小：788 K

文摘

Aims

To evaluate the efficacy of interstitial brachytherapy using ¹²⁵iodine (¹²⁵I) seeds for the treatment of recurrent multimodal treated medulloblastoma.

Materials and methods

Between September 1989 and August 2009, 12 patients (female:male = 3:9, median age 19 years, range 7?5 years) with 23 recurrent medulloblastomas underwent interstitial brachytherapy using ¹²⁵I seeds. Before brachytherapy, all patients underwent microsurgical resection; six patients underwent a combined adjuvant treatment consisting of craniospinal irradiation and chemotherapy; three received craniospinal irradiation alone and two received chemotherapy alone. One patient was treated by surgery alone. The median tumour volume was 4.9 ml (range 0.4?4.2 ml), the median tumour surface dose 50 Gy (range 32?0 Gy) and the median implantation time 42 days (range 42?0 days). A median follow-up of 26 months was available (range 5?16 months).

Results

After brachytherapy, nine of 23 tumours (39 % ) presented a complete remission, nine (39 % ) a partial remission and five (22 % ) stable disease on magnetic resonance images. The neurological status improved in six patients and remained unchanged in four. Two patients deteriorated: one developed spinal metastasis and another a treatment-related adverse radiation effect. Ten patients died due to disseminated disease despite local tumour control. The median survival after treatment was 15 months (range 5?8 months).

Conclusions

Our results show a good response of recurrent medulloblastoma after interstitial brachytherapy. High rates of tumour remission were yielded with low rates of treatment-related morbidity. Thus, ¹²⁵I seed brachytherapy should be considered as a treatment option for recurrent medulloblastoma.