Abstract
BackgroundThe prognosis of patients with progressive or recurrent high-grade gliomas (HGGs) after surgery remains poor. Iodine-125 brachytherapy is emerging 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 therapeutic method even without radiotherapy and/or chemotherapy for progressive or recurrent HGG after gross total resection.MethodsBetween March 2004 and August 2016, 58 patients with progressive or recurrent HGG after gross total resection were included in this study. Twenty-nine patients underwent radiotherapy and/or chemotherapy and then permanent iodine-125 brachytherapy (SRCI group). Twenty-nine patients underwent permanent iodine-125 brachytherapy alone (SI group). Follow-up was carried out at 1, 3, and 6 months and then at 1, 2, 3, and 5 years after iodine-125 implantation. The median overall survival (OS) and progression-free survival (PFS), procedure-related complications and clinical outcomes were evaluated.ResultsNo 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 21 and 7 months in the SRCI group. No significant differences were found. Age and Karnofsky Performance Status (KPS) were independent prognostic factors for OS. Age, KPS and histology were independent prognostic factors for PFS.ConclusionsPermanent iodine-125 brachytherapy could be used as an effective therapeutic method even without radiotherapy and/or chemotherapy for progressive or recurrent HGG after gross total resection.
Highlights
The prognosis of patients with progressive or recurrent high-grade gliomas (HGGs) after surgery remains poor
The implantation of iodine-125 seeds is a safe, accurate and effective treatment method with minimal invasion and a consecutive low-dose rate of radiation that places the seeds within the tumor [6, 9], which is different from external beam radiotherapy (EBRT)
We aimed to investigate whether permanent iodine-125 brachytherapy could be used as an effective therapeutic method even without radiotherapy and/or chemotherapy for progressive or recurrent HGG after gross total resection
Summary
The prognosis of patients with progressive or recurrent high-grade gliomas (HGGs) after surgery remains poor. Iodine-125 brachytherapy is emerging 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 therapeutic method even without radiotherapy and/or chemotherapy for progressive or recurrent HGG after gross total resection. For patients with progressive or recurrent HGG, repeated surgery is usually unfeasible, and radiotherapy and/or chemotherapy are usually chosen but are often not effective options; their safety remains a question [7]. Iodine-125 brachytherapy is emerging as a promising therapeutic method for gliomas that promotes the survival of patients [6, 8]. Iodine-125 brachytherapy has been suggested to be an effective salvage therapy for patients with progressive or recurrent gliomas [7, 10]; whether radiotherapy and chemotherapy before iodine-125 brachytherapy is necessary has not been explored
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