Interstitial thermoradiotherapy of brain tumors: Preliminary results of a phase I clinical trial
| Autor: | A. Norman Guthkelch, David S. Shimm, Eugenie Obbens, Robert P. Iacono, J. Robert Cassady, Baldassarre Stea, Joachim F. Seeger, Andrew G. Shetter, Thomas C. Cetas, Bruce Lulu, Kent Rossman, Wendell Lutz |
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| Rok vydání: | 1990 |
| Předmět: |
Adult
Male Hyperthermia Cancer Research medicine.medical_specialty medicine.medical_treatment Brachytherapy Phases of clinical research Astrocytoma medicine Humans Radiology Nuclear Medicine and imaging External beam radiotherapy Aged Radiation Brain Neoplasms business.industry Hyperthermia Induced Middle Aged medicine.disease Combined Modality Therapy Surgery Clinical trial Radiation therapy Oncology Female Implant Glioblastoma Tomography X-Ray Computed Nuclear medicine business Anaplastic astrocytoma |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 19:1463-1471 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/0360-3016(90)90359-r |
| Popis: | A Phase I clinical trial has been initiated to determine the feasibility, tolerance, and toxicity of interstitial thermoradiotherapy in the treatment of high-grade supratentorial brain gliomas. Hyperthermia was delivered by means of thermally-regulating ferromagnetic implants afterloaded into stereotactically placed plastic catheters. Heat treatments were given immediately before interstitial irradiation; in addition, five patients received a second heat treatment at the completion of brachytherapy. The desired target temperature for the 60-minute hyperthermia session was between 42 degrees C and 45 degrees C. Following hyperthermia, the catheters were afterloaded with Ir-192, which delivered a variable radiation dose of 14-50 Gy depending on the clinical situation. Interstitial irradiation was supplemented with external beam radiotherapy (40-41.4 Gy) in patients with previously untreated tumors. A total of 14 patients (4 males, 10 females) have been treated to date on this protocol. Eleven of the patients had a diagnosis of glioblastoma multiforme, whereas three had anaplastic astrocytoma. The mean implant volume was 61.5 cm3 (range: 9-119 cm3); the median number of interstitial treatment catheters implanted was 19 (range: 7-33). Continuous temperature monitoring was performed by means of multisensor thermocouple probes inserted in the center as well as in the periphery of the tumor. Of the 175 monitored intratumoral points, 83 (47%) had time-averaged mean temperatures of greater than 42 degrees C, and only 12 sensors (7%) exceeded a temperature of 45 degrees C. Among the 19 heat treatments attempted, there have been four minor acute toxicities, all of which resolved with conservative medical management and one major complication resulting in the demise of a patient. These preliminary results indicate that ferromagnetic implants offer a promising new approach to treating brain tumors with hyperthermia. |
| Databáze: | OpenAIRE |
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