Interstitial Radiation Therapy of Supratentorial Gliomas

Shanko Yu.*, Korotkevich Å.**, Osharin V.***, Minaylo I.***, Furmanchuk L.***, Sinayko V.***, Shalkovskaya I.***

* Belorussian Medical Academy of Postgraduate Education, Minsk, Belorussia;
** Scientific Practical Center of Neurology and Neurosurgery, Minsk, Belorussia;
*** Alexandrov Scientific Research Institute of Oncology and Medical Radiology, Minsk, Belorussia

 

The research goal was to improve methods of combined treatment of supratentorial gliomas.

Material and Methods. The results of treatment of 40 cases, aged 17-68, were analyzed. They had morphologically verified neuroepithelial gliomas (Grade II - 14, Grade III - 7, Grade IV - 19 cases). According to Karnofsky scale, their initial state was characterized by an index of not less than 60%.

Results and Discussion. The first stage of treatment consisted in tumor removal within the limits of intact tissue. It was followed by a course of interstitial radiation therapy (IRT) with a high-power dose (Ir192). When acute manifestations of postoperative brain edema regressed, guides for intrastats (1-7) were implanted parietally, using an open method. They were fixed in a subaponeurotic layer. Intrastats were inserted into the guides only for a period of irradiation session. A single dose of IRT was 5 Gy (2 sessions at 2.5 Gy each); a total dose was 25 Gy, which corresponded to 40 Gy in irradiation in a mode of conventional fractioning. The third stage was a course of distant radiation therapy with a total dose of 50 Gy. It was carried out 3 weeks after IRD completion. IRT via guides for intrastats was not accompanied by aggravation of a general condition of patients. There were no hemorrhagic and pyo-inflammatory complications or liquorrhea. A comparative assessment of treatment results, watched in main and control groups, was carried out (Kaplan-Meier method and the Log-rank test).

Conclusion. Use of the proposed method of combined treatment led to a fourfold reliable increase of twelve months’ survival in cases with high-grade cerebral gliomas.