Julow Jenö, Viola Arpád, Major Tibor, Valálik István, Sági Sarolta, Mangel László, Kovács Rita Beáta, Repa Imre, Bajzik Gábor, Németh György
Szent János Kórház és Rendelóintézet, Idegsebészeti Osztály, Budapest.
Ideggyogy Sz. 2004 Jan 20;57(1-2):30-5.
The optimal therapy of brain stem tumours of different histopathology determines the expected length of survival. Authors report 125Iodine interstitial irradiation of brain stem tumours with stereotactic brachytherapy.
Two patients having brain stem tumours were suffering from glioma or from metastases of a carcinoma. In Case 1 the tumour volume was 1.98 cm3 at the time of planning interstitial irradiation. The control MRI examination performed at 42 months post-op showed a postirradiation cyst size of 5.73 cm3 indicating 65.5% shrinkage. In Case 2 the shrinkage was more apparent as the tumour volume measured on the control MRI at 8 months post-op was only 0.16 cm3 indicating 97.4% shrinkage of the 6.05 cm3 target volume at the time of brachytherapy with the metastasis practically disappearing. Quick access to histopathological results of the stereotactic intraoperative biopsy made it possible to carry out the 125Iodine stereotactic brachytherapy immediately after the biopsy, resulting in less inconvenience for patients of a second possible intervention. The control MRI scans show significant shrinkage of tumours in both patients.
The procedure can be performed as a biopsy. The CT and image fusion guided 125Iodine stereotactic brachytherapy can be well planned dosimetrically and is surgically precise.
