[The value of fractionated afterloading therapy in the treatment of inoperable malignant brain tumor].

Since 1985, inoperable brain tumors, astrocytoma III or glioblastoma multiforme, have been treated by means of fractionated afterloading therapy combines with subsequent percutaneous irradiation. A screw that was specifically designed, allowed us to fix a precious metal tube to the skull cap for about eight days making possible the application of a marginal tumor dose of 30 Gy at a daily fractionation of 2 X 2 Gy using the iridium-afterloading-technique. Percutaneous saturation with another 30-40 Gy followed. Supported by radiobiological considerations, fractionation also appears to have a favorable influence on the perifocal edema formation in the brachytherapy of malignant brain tumors. After an observation period of four years probabilities of survival amounting to six months and twelve months can be calculated (according to Kaplan-Meier) for 68% and 27% of the total collective, respectively (n = 38). The survival rate for patients without pretreatment (n = 16) was 81% and 41% after six and twelve months respectively.