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Andreas[a]

J Neurooncol. 2003 May;62(3):321-8.

Locoregional radioimmunotherapy in selected patients with malignant glioma: experiences, side effects and survival times.

Goetz C, Riva P, Poepperl G, Gildehaus FJ, Hischa A, Tatsch K, Reulen HJ.

Neurochirurgische Klinik der Ludwig-Maximilians-Universitat, Munchen, Germany.

Prognosis of malignant glioma is very unfavourable mainly due to minimal tumour remnants in the peritumoural tissue. Intralesionally applied radioimmunotherapy is a possible therapeutical option with the potential to improve survival of patients with malignant glioma. We investigated side effects and survival after surgery, conventional radiotherapy and additional radioimmunotherapy with labelled tenascin-antibodies in patients with malignant glioma.

METHODS:
Since 1995, 37 patients were treated with radioimmunotherapy after resection and radiotherapy of a malignant glioma. Patients received antibodies labelled with yttrium-90 and iodine-131 in different doses into the tumour cavity via a previously implanted ommaya-reservoir. Treatment was applied in up to 8 cycles
(mean 2.96 cycles) in time intervals of 6-8 weeks. Mean age was 46 years, histology was anaplastic astrocytoma in 13 patients and glioblastoma in 24 patients.

RESULTS:
For the whole group median survival time has not yet been reached. For glioblastoma the median survival time is 17 months, 5-year survival probability for anaplastic astrocytoma is 85% approximately. Quality of life was acceptable. Acute side effects following treatment were headache, seizures and worsening of pre-existing neurological symptoms. Late side effects were skin necrosis and, in 1 case, a delayed aphasia probably due to a vascular lesion.

CONCLUSION:
Radioimmunotherapy prolonged survival time in a selected group of patients with malignant gliomas as compared to a historical control group.
Patients with anaplastic astrocytomas seem to have more benefit from this therapy than patients with glioblastomas.

PMID

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