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Interstitial brachytherapy using stereotactic implanted (125)iodine seeds for recurrent medulloblastoma

AIMS: To evaluate the efficacy of interstitial brachytherapy using (125)iodine ((125)I) 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 7-55 years) with 23 recurrent medulloblastomas underwent interstitial brachytherapy using (125)I 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 4.9ml (range 0.4-44.2ml), the median tumour surface dose 50Gy (range 32-50Gy) and the median implantation time 42 days (range 42-90 days). A median follow-up of 26 months was available (range 5-116 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 5-68 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, (125)I seed brachytherapy should be considered as a treatment option for recurrent medulloblastoma

Keywords : Adolescent,Adult,Brachytherapy,Cerebellar Neoplasms,Child,Female,Follow-Up Studies,Germany,Humans,Iodine Radioisotopes,Male,Medulloblastoma,methods,Middle Aged,Morbidity,Neoplasm Recurrence,Local,Neurosurgery,pathology,Prognosis,Radioisotopes,radiotherapy,Salvage Therapy,surgery,Survival Rate,therapeutic use,Young Adult,, Brachytherapy,Using,Stereotactic,Implanted,(125)Iodine, can reflexology help back pain

Date of Publication : 2011 Oct

Authors : El MF;Simon T;Hoevels M;Berthold F;Sturm V;Maarouf M;

Organisation : Department of Stereotaxy and Functional Neurosurgery, University of Cologne, Germany

Journal of Publication : Clin Oncol (R Coll Radiol )

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/21440428

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