Brachytherapy for brain tumors

Abstract

Over the past several decades neurooncologists have attempted to find an adjuvant treatment that prolongs survival for patients with malignant brain tumors. Brachytherapy, radiotherapy delivered by placing radioactive sources directly into the tumor, was initially thought to be the solution to this problem. Initial single institution studies showed very promising results; however, this technique has failed to show a significant survival advantage in two randomized studies. Despite this, brachytherapy continues to be used in a number of centers throughout the world for the treatment of various types of brain tumors including low-grade gliomas, anaplastic astrocytomas, glioblastomas, meningiomas and metastases. This article reviews brachytherapy's rationale, radiobiology, complications, indications, and results from numerous studies that have focused on its application for brain tumors with emphasis on its application for glial tumors.

Brachytherapy in treatment of brain tumors

“…Ó б³ëüшîñò³ äîñë³äaeåíü, â яêèх îö³íåíî åфåêòèâ-í³ñòü БТ, íå âêëючàюòü хâîðèх, яê³ñòü aeèòòя яêèх зà шêàëîю Êàðíîâñüê³ îö³íåíà мåíшå 70 бàë³â [8]. Пðîòå, äåяê³ äîñë³äíèêè îö³íèëè ïàë³àòèâíó ðîëü ö³є¿ òåðàﳿ зàм³ñòü ñòàíäàðòíîãî îïðîм³íåííя ó хâîðèх, Примітка.…”

“…Âíàñë³äîê òàêîãî ñóâîðîãî â³äбîðó ëèшå 10-30% ïàö³єíò³â з ïðèâîäó íèзüêîäèфåðåíö³é-îâàíèх ãë³îм ïîêàзàíå ïðî-âåäåííя БТ. Êð³м òîãî, ó öèх ïàö³єíò³â мàюòü бóòè ñïðèяò-ëèâ³ ïðîãíîñòèчí³ êðèòå𳿠(â³ê, шêàëà Êàðíîâñüê³, ä³àмåòð ïóхëèíè) [8].…”

“…Ó 1912 ð. Hirsch ïåðшèм îïèñàâ БТ яê мåòîä ë³êóâàííя ïóхëèí öåíòðàëüíî¿ íåðâîâî¿ ñèñòåмè [8]. Пðîòå, ðîзâèòîê íå³íâàзèâíèх мåòîä³â зîâ-í³шíüîãî îïðîм³íåííя íà òðèâàëèé чàñ зàòðèмàâ âïðîâàäaeåííя БТ â êë³í³чíó ïðàêòèêó.…”

Síndrome de Nelson: relato de caso

“…Podem ocorrer lesões que não ocasionam morte das células e sim mutações genéticas que culminam em diminuição da proliferação celular. O fato de a fonte de irradiação estar dentro da lesão é uma das maiores vantagens da braquiterapia em relação aos outros métodos, já que possibilita que a dose de radiação que o tecido neoplásico recebe seja maior, porque o isótopo permanece por tempo prolongado no sítio de irradiação, e sua administração é feita de modo contínuo e existe menor irradiação a tecidos vizinhos (40). Em função disso, a braquiterapia é menos lesiva para o tecido normal perilesional e isto permite repetição ilimitada deste procedimento em um mesmo indivíduo ou na mesma região.…”

Intracavitary moderator balloon combined with252Cf brachytherapy and boron neutron capture therapy, improving dosimetry in brain tumour and infiltrations

“…However, recent studies have investigated the use of brachytherapy as an initial treatment at the time of diagnosis. 37,38,39 Usually, 125 I and 192 Ir are the isotopes employed in brachytherapy for brain tumour treatment, 40,41 but 252 Cf has also been used in brain tumour therapy with some hopeful results. 18,37,41 During the past few years, the 125 I-brachytherapy modality has been developed.…”