Locoregional
radioimmunotherapy in selected patients with malignant glioma: experiences, side
effects and survival times
C.
Goetz^, P.
Riva*, G. Poepperl+, F.J.
Gildehaus+, A.
Hischa^, K.
Tatsch+, H.-J.
Reulen^
^Neurochirurgische
Klinik der Ludwig-Maximilians-Universität,
München,
Germany;
*Servizio di medicina nucleare, Ospedale Maurizio Bufalini, Cesena, Italien;
+Klinik und Poliklinik für
Nuklearmedizin der Ludwig-Maximilians-Universität,
München,
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.
Keywords:
glioma, malignant, antibody,
tenascin, therapy, radioimmunotherapy
Copyright ©
2003 Kluwer Academic Publishers. All rights
reserved
Source: http://www.kluweronline.com/issn/0167-594X/contents |
