INITIAL RESULTS IN RECURRENT BRAIN GLIOBLASTOMAS MANAGEMENT WITH MAXIMAL SAFE RESECTION FOLLOWED BY INTAOPERATIVE BALLOON ELECTRONIC BRACHYTERAPY
Orkhan Al’zaminogly ABDULLAEV1,2, Aleksey Sergeevich GAYTAN2, Nidal SALIM2, Gleb Sergeevich SERGEEV2, Il’ya Vladimirovich MARMAZEEV2, Evaldas CHESNULIS3, Aleksey Leonidovich KRIVOSHAPKIN1,2
1Novosibirsk State Medical University of Minzdrav of Russia
2European Medical Center
3Klinik Hirslanden, Neurochirurgie Hirslanden
Keywords: глиобластома, резекция глиом, радикальность резекции, лучевая терапия, брахитерапия, интраоперационная лучевая терапия, glioblastoma, glioma resection, radical resection, radiation therapy, brachytherapy, intraoperative radiation therapy
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.
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