Neutron interstitial brachytherapy for malignant gliomas: A pilot study

R. A. Patchell, Y. Maruyama, P. A. Tibbs, J. L. Beach, R. J. Kryscio, A. B. Young

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Fifty-six patients with malignant glioma were treated with implantation of the neutron-emitting element californium-252 (252Cf) within 2 weeks after surgical debulking of the tumor. Implantation was performed using computerized tomography-guided placement of afterloading cathers, and the 252Cf sources were removed after approximately 300 neuutron rads were delivered. Patients then received 6000 to 7000 conventional photon rads by external beam. The total photon-equivalent dose to the tumor ranged from 8100 to 9100 rads. The median survival time was 10 months, and 18- and 24-month survival rates of 28% and 19%, respectively. The results of reoperation or autopsy showed that patients had recurrence of the tumor but that radiation necrosis was restricted to the area of the original tumor. Serious complications occurred in five patients (9%) and consisted of wound infections in three, cerebral edema in one, and radiation necrosis beyond the original tumor margin in one. Previous studies using external-beam neutron radiation have shown that neutrons are capable of totally eradicating malignant gliomas; however, in most cases, unacceptable widespread radiation necrosis has resulted. Neutron implants are a logical way to increase the dose to the tumor and decrease the dose to normal brain. Interstitial neutron radiation can be given safely with 252Cf, and the survival results achieved by radiation alone using relatively low doses of interstitial neutron radiation from 252Cf implants plus conventional photon radiation were equal to the results attained with any currently available conventional therapy.

Original languageEnglish
Pages (from-to)67-72
Number of pages6
JournalJournal of Neurosurgery
Volume68
Issue number1
DOIs
StatePublished - 1988

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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