PMID- 33622365
OWN - NLM
STAT- MEDLINE
DCOM- 20211014
LR  - 20211014
IS  - 1748-717X (Electronic)
IS  - 1748-717X (Linking)
VI  - 16
IP  - 1
DP  - 2021 Feb 23
TI  - Radiation necrosis after a combination of external beam radiotherapy and 
      iodine-125 brachytherapy in gliomas.
PG  - 40
LID - 10.1186/s13014-021-01762-0 [doi]
LID - 40
AB  - PURPOSE: Frequency and risk profile of radiation necrosis (RN) in patients with 
      glioma undergoing either upfront stereotactic brachytherapy (SBT) and additional 
      salvage external beam radiotherapy (EBRT) after tumor recurrence or vice versa 
      remains unknown. METHODS: Patients with glioma treated with low-activity 
      temporary iodine-125 SBT at the University of Munich between 1999 and 2016 who 
      had either additional upfront or salvage EBRT were included. Biologically 
      effective doses (BED) were calculated. RN was diagnosed using stereotactic biopsy 
      and/or metabolic imaging. The rate of RN was estimated with the Kaplan Meier 
      method. Risk factors were obtained from logistic regression models. RESULTS: 
      Eighty-six patients (49 male, 37 female, median age 47 years) were included. 38 
      patients suffered from low-grade and 48 from high-grade glioma. Median follow-up 
      was 15 months after second treatment. Fifty-eight patients received upfront EBRT 
      (median total dose: 60 Gy), and 28 upfront SBT (median reference dose: 54 Gy, 
      median dose rate: 10.0 cGy/h). Median time interval between treatments was 
      19 months. RN was diagnosed in 8/75 patients. The 1- and 2-year risk of RN was 
      5.1% and 11.7%, respectively. Tumor volume and irradiation time of SBT, number of 
      implanted seeds, and salvage EBRT were risk factors for RN. Neither of the BED 
      values nor the time interval between both treatments gained prognostic influence. 
      CONCLUSION: The combination of upfront EBRT and salvage SBT or vice versa is 
      feasible for glioma patients. The risk of RN is mainly determined by the 
      treatment volume but not by the interval between therapies.
FAU - Hadi, Indrawati
AU  - Hadi I
AD  - Department of Radiation Oncology, University Hospital, LMU Munich, 
      Marchioninistr. 15, 81377, Munich, Germany.
FAU - Reitz, Daniel
AU  - Reitz D
AD  - Department of Radiation Oncology, University Hospital, LMU Munich, 
      Marchioninistr. 15, 81377, Munich, Germany.
FAU - Bodensohn, Raphael
AU  - Bodensohn R
AD  - Department of Radiation Oncology, University Hospital, LMU Munich, 
      Marchioninistr. 15, 81377, Munich, Germany.
FAU - Roengvoraphoj, Olarn
AU  - Roengvoraphoj O
AD  - Department of Radiation Oncology, University Hospital, LMU Munich, 
      Marchioninistr. 15, 81377, Munich, Germany.
FAU - Lietke, Stefanie
AU  - Lietke S
AD  - Department of Neurosurgery, University Hospital, LMU Munich, Munich, Germany.
FAU - Niyazi, Maximilian
AU  - Niyazi M
AD  - Department of Radiation Oncology, University Hospital, LMU Munich, 
      Marchioninistr. 15, 81377, Munich, Germany.
AD  - German Cancer Consortium (DKTK), Munich, Germany.
FAU - Tonn, Jorg-Christian
AU  - Tonn JC
AD  - Department of Neurosurgery, University Hospital, LMU Munich, Munich, Germany.
FAU - Belka, Claus
AU  - Belka C
AD  - Department of Radiation Oncology, University Hospital, LMU Munich, 
      Marchioninistr. 15, 81377, Munich, Germany.
AD  - German Cancer Consortium (DKTK), Munich, Germany.
FAU - Thon, Niklas
AU  - Thon N
AD  - Department of Neurosurgery, University Hospital, LMU Munich, Munich, Germany.
FAU - Nachbichler, Silke Birgit
AU  - Nachbichler SB
AUID- ORCID: 0000-0003-3860-5235
AD  - Department of Radiation Oncology, University Hospital, LMU Munich, 
      Marchioninistr. 15, 81377, Munich, Germany. 
      silke.nachbichler@med.uni-muenchen.de.
LA  - eng
PT  - Journal Article
DEP - 20210223
PL  - England
TA  - Radiat Oncol
JT  - Radiation oncology (London, England)
JID - 101265111
RN  - 0 (Iodine Radioisotopes)
RN  - GVO776611R (Iodine-125)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Brachytherapy/adverse effects
MH  - Female
MH  - Glioma/pathology/*radiotherapy
MH  - Humans
MH  - Iodine Radioisotopes/adverse effects
MH  - Male
MH  - Middle Aged
MH  - Necrosis
MH  - *Neoplasm Recurrence, Local
MH  - Radiation Injuries/diagnosis/*etiology/pathology
MH  - Radiotherapy Dosage
MH  - Re-Irradiation/*adverse effects
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Salvage Therapy/adverse effects
MH  - Treatment Outcome
MH  - Young Adult
PMC - PMC7903688
OTO - NOTNLM
OT  - External beam radiotherapy
OT  - Prognostic factors
OT  - Radiation necrosis
OT  - Re-irradiation
OT  - Stereotactic brachytherapy
COIS- The authors declare that they have no competing interests.
EDAT- 2021/02/25 06:00
MHDA- 2021/10/15 06:00
PMCR- 2021/02/23
CRDT- 2021/02/24 05:33
PHST- 2020/09/03 00:00 [received]
PHST- 2021/02/11 00:00 [accepted]
PHST- 2021/02/24 05:33 [entrez]
PHST- 2021/02/25 06:00 [pubmed]
PHST- 2021/10/15 06:00 [medline]
PHST- 2021/02/23 00:00 [pmc-release]
AID - 10.1186/s13014-021-01762-0 [pii]
AID - 1762 [pii]
AID - 10.1186/s13014-021-01762-0 [doi]
PST - epublish
SO  - Radiat Oncol. 2021 Feb 23;16(1):40. doi: 10.1186/s13014-021-01762-0.