Abstract
Brain glioblastomas (GBM) are notorious for their early local recurrence despite of standard combined treatment. Technologies for recurrent GBM management require further development and research. Resection of malignant gliomas must be followed by an adjuvant treatment. Intraoperative balloon electronic brachytherapy (IBEB) has been recently introduced into clinical practice and could be successfully applied to recurrent GBM management. This article presents the initial results of recurrent GBM management with maximal safe resection followed by IBEB. Material and methods . Patients (n = 11) with recurrent GBM after standard combined treatment were managed with maximal safe microsurgical resection followed by IBEB. The follow-up period after IBEB ranged from 1 to 30 months. Results. The median overall survival for the entire study group of patients included in the statistical analysis (n = 9) was 27 months (range 17–47 months). In the subgroup of patients (n = 4) with contrast-enhanced tumor MRI volume after resection ≤ 2.5 cm3, the median local progression free survival (locPFS) was 21.25 months (range 10–30 months). Conclusion. Initial results in recurrent brain GBMs management with resection followed by IBEB seems to be promising, especially in case of contrast-enhanced tumor volume detected on MRI after resection is less than 2.5 cm3 without signs of multifocal tumor growth.
Highlights
This article presents the initial results of recurrent GBM management with maximal safe resection followed by Intraoperative balloon electronic brachytherapy (IBEB)
Patients (n = 11) with recurrent GBM after standard combined treatment were managed with maximal safe microsurgical resection followed by IBEB
Initial results in recurrent brain GBMs management with resection followed by IBEB seems to be promising, especially in case of contrast-enhanced tumor volume detected on MRI after resection is less than 2.5 cm3 without signs of multifocal tumor growth
Summary
Исследование носит проспективный когортный характер и проходит на базе клиники АО «Европейский медицинский центр» после одобрения локальным этическим комитетом Новосибирского государственного медицинского университета (протокол No 17 от 11.05.2017). Критерии включения в исследование: признаки рецидива ГБ по данным МРТ головного мозга с контрастированием, МРперфузии и/или позитронно-эмиссионной томографии, совмещенной с компьютерной томографией (ПЭТ-КТ), головного мозга с 18F-DOPA, возраст ≥18 лет, индекс Карновского ≥50 %. Для оценки безрецидивной и общей выживаемости, а также наличия и выраженности побочных эффектов проводился томографический контроль с применением МРТ головного мозга с контрастированием и перфузией в течение 24 ч после операции, а затем МРТ головного мозга с контрастированием и перфузией и/или ПЭТ-КТ головного мозга с L-6-[18F]фтор-3,4-диоксифе нилаланином (18F-DOPA) 1 раз в 3 месяца до возникновения рецидива опухоли. T1 tse fatsat аксиальные срезы, постконтрастное исследование 4 мм; FOV 230 мм; матрица 320; TR/TE 582/8.9 мс. The main clinical and tomographic characteristics of patients and their survival rates
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