Radiation necrosis after a combination of external beam radiotherapy and iodine-125 brachytherapy in gliomas.
Adolescent
Adult
Aged
Brachytherapy
/ adverse effects
Female
Glioma
/ pathology
Humans
Iodine Radioisotopes
/ adverse effects
Male
Middle Aged
Necrosis
Neoplasm Recurrence, Local
Radiation Injuries
/ diagnosis
Radiotherapy Dosage
Re-Irradiation
/ adverse effects
Retrospective Studies
Risk Factors
Salvage Therapy
/ adverse effects
Treatment Outcome
Young Adult
External beam radiotherapy
Prognostic factors
Radiation necrosis
Re-irradiation
Stereotactic brachytherapy
Journal
Radiation oncology (London, England)
ISSN: 1748-717X
Titre abrégé: Radiat Oncol
Pays: England
ID NLM: 101265111
Informations de publication
Date de publication:
23 Feb 2021
23 Feb 2021
Historique:
received:
03
09
2020
accepted:
11
02
2021
entrez:
24
2
2021
pubmed:
25
2
2021
medline:
15
10
2021
Statut:
epublish
Résumé
Frequency and risk profile of radiation necrosis (RN) in patients with glioma undergoing either upfront stereotactic brachytherapy (SBT) and additional salvage external beam radiotherapy (EBRT) after tumor recurrence or vice versa remains unknown. Patients with glioma treated with low-activity temporary iodine-125 SBT at the University of Munich between 1999 and 2016 who had either additional upfront or salvage EBRT were included. Biologically effective doses (BED) were calculated. RN was diagnosed using stereotactic biopsy and/or metabolic imaging. The rate of RN was estimated with the Kaplan Meier method. Risk factors were obtained from logistic regression models. Eighty-six patients (49 male, 37 female, median age 47 years) were included. 38 patients suffered from low-grade and 48 from high-grade glioma. Median follow-up was 15 months after second treatment. Fifty-eight patients received upfront EBRT (median total dose: 60 Gy), and 28 upfront SBT (median reference dose: 54 Gy, median dose rate: 10.0 cGy/h). Median time interval between treatments was 19 months. RN was diagnosed in 8/75 patients. The 1- and 2-year risk of RN was 5.1% and 11.7%, respectively. Tumor volume and irradiation time of SBT, number of implanted seeds, and salvage EBRT were risk factors for RN. Neither of the BED values nor the time interval between both treatments gained prognostic influence. The combination of upfront EBRT and salvage SBT or vice versa is feasible for glioma patients. The risk of RN is mainly determined by the treatment volume but not by the interval between therapies.
Identifiants
pubmed: 33622365
doi: 10.1186/s13014-021-01762-0
pii: 10.1186/s13014-021-01762-0
pmc: PMC7903688
doi:
Substances chimiques
Iodine Radioisotopes
0
Iodine-125
GVO776611R
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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