Intracranial ganglioglioma WHO I: results in a series of eight patients treated with stereotactic interstitial brachytherapy

• Published in: Journal of neuro-oncology 2014-06, Vol.118 (2), p.345-350
• Main Authors: El Majdoub, Faycal, Rezk, Essam, Hunsche, Stefan, Bührle, Christian, Sturm, Volker, Maarouf, Mohammad
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Brachytherapy - adverse effects; Brachytherapy - methods; Brain Neoplasms - pathology; Brain Neoplasms - surgery; Child; Clinical Study; Contrast Media; Female; Follow-Up Studies; Gadolinium; Ganglioglioma - pathology; Ganglioglioma - surgery; Humans; Iodine Radioisotopes - adverse effects; Iodine Radioisotopes - therapeutic use; Magnetic Resonance Imaging; Male; Medicine; Medicine & Public Health; Microsurgery; Neoplasm Staging; Neurology; Oncology; Radiosurgery - adverse effects; Radiosurgery - methods; Radiotherapy Planning, Computer-Assisted; Remission Induction; Retreatment; Retrospective Studies; Treatment Outcome; Young Adult
• ISSN: 0167-594X; 1573-7373
• DOI: 10.1007/s11060-014-1438-x

In this retrospective study we evaluated the efficacy of interstitial brachytherapy (IBT) using 125 Iodine seeds ( 125 I) for intracranial ganglioglioma WHO I. Between October 1994 and March 2010, eight patients (m/f = 5/3, median age 30.4 years, age range 7–42.5 years) with intracranial ganglioglioma WHO I were treated with IBT using stereotactically implanted 125 I seeds. The median follow-up time was 41.5 months (range 16.7–140.1 months). Prior to interstitial brachytherapy one patient underwent microsurgical resection for three times; seven patients were treated with IBT primarily. In all patients we implanted the 125 I seeds stereotactically guided. The cumulative tumor surface dose ranged between 50 and 65 Gy (permanent implantation) and the median tumor volume was 5.6 ml (range 0.9–26 ml). After brachytherapy, follow-up MR imaging revealed complete remission in one patient, partial remission in three and stable disease in the remaining four patients. Five of eight patients presented with seizures were either seizure-free (1/5) or improved (4/5). Temporary treatment-related morbidity occurred in one patient only (headache, nausea/vomiting) and resolved completely under steroid medication after 4 weeks. No treatment-related mortality was observed. This study indicates that interstitial brachytherapy for the treatment of intracranial ganglioglioma WHO I is safe and provides a high rate of local tumor control. Due to the limited number of cases, it is not possible to conduct a rigorous statistical evaluation. Thus, larger numbers of patients are required.