CT guided interstitial high dose rate brachytherapy for recurrent malignant gliomas

This paper describes the technique and preliminary results of high dose rat e (HDR) interstitial brachytherapy for recurrent grade III and grade IV gli omas. Although in the initial treatment of malignant gliomas brachytherapy has been shown to give better results than external beam therapy, this has previously always been with low dose rate (LDR) brachytherapy. Stereotactic frames are used for interstitial LDR brachytherapy but a CT image-guided t echnique does not require such a frame. The survival rates for our initial 53 patients do not significantly differ from LDR results. However, using HD R there are several advantages, including a much shorter treatment time wit h HDR than LDR and better patient comfort. HDR also allows better individua lized optimization of the treatment than LDR.