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Brachytherapy for Recurrent Single Brain Metastasis

Published online by Cambridge University Press:  18 September 2015

Mark Bernstein ,
Alberto Cabantog ,
Normand Laperriere ,
Phil Leung  and
Cindy Thomason
Mark Bernstein*
Affiliation:
Division of Neurosurgery, The Toronto Hospital
Alberto Cabantog
Affiliation:
Division of Neurosurgery, The Toronto Hospital
Normand Laperriere
Affiliation:
Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto
Phil Leung
Affiliation:
Department of Physics, Princess Margaret Hospital, University of Toronto, Toronto
Cindy Thomason
Affiliation:
Department of Physics, Princess Margaret Hospital, University of Toronto, Toronto
*
Division of Neurosurgery, The Toronto Hospital, Suite 2-405, McLaughlin Pavilion, 399 Bathurst Street, Toronto, Ontario, Canada M5T 2S8
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Abstract:

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Of 112 stereotactic high-activity iodine-125 implants for malignant brain tumors done as of July 1, 1994, ten have been done for recurrent single brain metastasis and constitute the study group described herein. All patients had initially undergone craniotomy for tumor resection followed by fractionated external beam whole brain radiation and recurred at the same site in the brain. The interval between initial cancer therapy and occurrence of the brain metastasis was 13 – 156 weeks (median: 63 weeks). The interval between initial treatment of the brain metastasis and its recurrence treated with brachytherapy was 13-69 weeks (median: 35 weeks). Minimum brachytherapy dose administered was 70 Gy at a median dose rate of 67 cGy/hour. Eight- patients have died. Two died suddenly at 2 and 13 weeks post-implant of presumed pulmonary embolus. Five died of recurrence of the brain metastasis at 20, 39, 52, 103, and 143 weeks post-implant, and one died of systemic metastases at 40 weeks post-implant. Two patients remain alive 183 and 324 weeks post-implant. High-activity iodine-125 brachytherapy appears to be of benefit for selected patients with recurrent single brain metastasis but larger, and preferably randomized studies are needed.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 22 , Issue 1 , February 1995 , pp. 13 - 16
Copyright
Copyright © Canadian Neurological Sciences Federation 1995

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