Permanent Iodine-125 Brachytherapy for Patients with Progressive or Recurrent High-Grade Gliomas

Abstract

Background: The prognosis of patients with progressive or recurrent high-grade gliomas (HGG) after surgery remains poor. Iodine-125 brachytherapy emerges as a salvage method for the treatment of gliomas. This study aimed to investigate whether permanent iodine-125 brachytherapy could be used as an effective therapy method even without radiotherapy and/or chemotherapy, for the progressive or recurrent HGG after gross total surgery. Methods: Between March 2004 and August 2016, 58 patients with progressive or recurrent HGG after gross total surgery were included in this study. 29 of them received radiotherapy and/or chemotherapy, and then permanent iodine-125 brachytherapy (SRCI group). 29 of them received permanent iodine-125 brachytherapy alone (SI group). Follow-up was carried out 1, 3, 6 months and then 1, 2, 3, 5 years after iodine-125 implantation. Median overall survival (OS), progression-free survival (PFS), procedure-related complications and clinical outcome were evaluated. Findings: No procedure-related fatal events happened. The temporary morbidity rate was 11.9%. The median OS and PFS for patients in the SI group were 22 and 8 months compared with 21and 7 months in the SRCI group. No significant differences were found. Age and KPS were the independent prognostic factors of OS. Age, KPS and histology were the independent prognostic factors of PFS. Interpretation: Permanent iodine-125 brachytherapy could be used as an effective therapy method even without radiotherapy and/or chemotherapy, for the progressive or recurrent HGG after gross total surgery. Funding Statement: This work was supported by the National Science Foundation for Youths of China (NO. 81901800). Declaration of Interests: The authors stated: There are no conflicts of interest to declare. Ethics Approval Statement: The study was approved by the Institutional Ethics Review Boards of each hospital with the requirement of informed consent waived.