THERMORADIOTHERAPY FOR BRAIN-TUMORS - 3 CASES OF RECURRENT MALIGNANT ASTROCYTOMA AND REVIEW OF CLINICAL-EXPERIENCE

Three patients with symptomatic, recurrent supratentorial malignant as trocytoma were retreated with combined interstitial iridium-192 brachy therapy (RT) and hyperthermia (HT): 50 Gy at 50 cGy/h was delivered 10 mm outside the computed tomography (CT) enhancement border through st ereotactically placed plastic tubes, and 915-MHz microwave antenna hea ting was done for 60 min within 30 min either before or after irradiat ion. Invasive thermometry data were obtained from the tumor and adjace nt brain tissue, The patients tolerated the treatment well and two thi rds improved. All patients developed cerebral edema, one also develope d scalp infection, and another patient developed meningeal infection, Exceeding the expectancy without treatment, overall survival was 7, 12 , and 15 months. On autopsy, two of the patients' brains revealed no a ctive tumor in the treated regions, but one displayed tumor in untreat ed parts. The HT-RT treatment was very effective, but the original tum or extent was not apparent by the CT imaging technique. A postimplant resection approach may be advisable to minimize postimplant edema, Our data are in agreement with the available literature on more than 400 patients, However, our aim of extending survival decisively could not be realized.