Feasibility of combined operation and perioperative intensity-modulated brachytherapy of advanced/recurrent malignancies involving the skull base
To assess the technical feasibility and toxicity of combined operation and perioperative intensity-modulated fractionated interstitial brachytherapy (IMBT) in advanced-stage malignancies involving the skull base with the goal of preserving the patients' senses of sight. This series consisted of...
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| Veröffentlicht in: | Strahlentherapie und Onkologie 2005-02, Vol.181 (2), p.97-107 |
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| creator | Strege, Rainer J Kovács, György Maune, Steffen Holland, Detlef Niehoff, Peter Eichmann, Thomas Mehdorn, H Maximilian |
| description | To assess the technical feasibility and toxicity of combined operation and perioperative intensity-modulated fractionated interstitial brachytherapy (IMBT) in advanced-stage malignancies involving the skull base with the goal of preserving the patients' senses of sight.
This series consisted of 18 consecutive cases: ten patients with paranasal sinus carcinomas, five with sarcomas, two with primitive neuroectodermal tumors (PNETs), and one with parotid gland carcinoma. After, in most cases, subtotal surgical resection (R1-R2: carried out so that the patients' senses of sight were preserved), two to twelve (mean five) afterloading plastic tubes were placed into the tumor bed. IMBT was performed with an iridium-192 stepping source in pulsed-dose-rate/high-dose-rate (PDR/HDR) afterloading technique. The total IMBT dose, ranging from 10 to 30 Gy, was administered in a fractionated manner (3-5 Gy/day, 5 days/week).
Perioperative fractionated IMBT was performed in 15 out of 18 patients and was well tolerated. Complications that partially prevented or delayed IMBT in some cases included cerebrospinal fluid leakage (twice), meningitis (twice), frontal brain syndrome (twice), afterloading tube displacement (twice), seizure (once), and general morbidity (once). No surgery- or radiation-induced injuries to the cranial nerves or eyes occurred. Median survival times were 33 months after diagnosis and 16 months after combined operation and IMBT.
Perioperative fractionated IMBT after extensive but vision-preserving tumor resection seems to be a safe and well-tolerated treatment of advanced/recurrent malignancies involving the skull base. These preliminary data suggest that combined operation and perioperative fractionated IMBT is a palliative therapeutic option in the management of fatal malignancies involving the base of the skull, a strategy which leaves the patients' visual acuity intact. |
| doi_str_mv | 10.1007/s00066-005-1274-1 |
| format | Article |
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This series consisted of 18 consecutive cases: ten patients with paranasal sinus carcinomas, five with sarcomas, two with primitive neuroectodermal tumors (PNETs), and one with parotid gland carcinoma. After, in most cases, subtotal surgical resection (R1-R2: carried out so that the patients' senses of sight were preserved), two to twelve (mean five) afterloading plastic tubes were placed into the tumor bed. IMBT was performed with an iridium-192 stepping source in pulsed-dose-rate/high-dose-rate (PDR/HDR) afterloading technique. The total IMBT dose, ranging from 10 to 30 Gy, was administered in a fractionated manner (3-5 Gy/day, 5 days/week).
Perioperative fractionated IMBT was performed in 15 out of 18 patients and was well tolerated. Complications that partially prevented or delayed IMBT in some cases included cerebrospinal fluid leakage (twice), meningitis (twice), frontal brain syndrome (twice), afterloading tube displacement (twice), seizure (once), and general morbidity (once). No surgery- or radiation-induced injuries to the cranial nerves or eyes occurred. Median survival times were 33 months after diagnosis and 16 months after combined operation and IMBT.
Perioperative fractionated IMBT after extensive but vision-preserving tumor resection seems to be a safe and well-tolerated treatment of advanced/recurrent malignancies involving the skull base. These preliminary data suggest that combined operation and perioperative fractionated IMBT is a palliative therapeutic option in the management of fatal malignancies involving the base of the skull, a strategy which leaves the patients' visual acuity intact.</description><identifier>ISSN: 0179-7158</identifier><identifier>EISSN: 1439-099X</identifier><identifier>DOI: 10.1007/s00066-005-1274-1</identifier><identifier>PMID: 15702298</identifier><language>eng</language><publisher>Germany: Springer Nature B.V</publisher><subject>Adolescent ; Adult ; Algorithms ; Brachytherapy - adverse effects ; Brachytherapy - methods ; Child ; Child, Preschool ; Eye Injuries - etiology ; Eye Injuries - prevention & control ; Feasibility Studies ; Female ; Germany - epidemiology ; Humans ; Infant ; Male ; Middle Aged ; Neoplasm Recurrence, Local - mortality ; Neoplasm Recurrence, Local - radiotherapy ; Neoplasm Recurrence, Local - surgery ; Palliative Care ; Perioperative Care - adverse effects ; Perioperative Care - methods ; Radiation Injuries - etiology ; Radiation Injuries - prevention & control ; Radiation therapy ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted - methods ; Radiotherapy, Adjuvant - adverse effects ; Radiotherapy, Adjuvant - methods ; Salvage Therapy - methods ; Severity of Illness Index ; Skull Neoplasms - mortality ; Skull Neoplasms - radiotherapy ; Skull Neoplasms - surgery ; Survival Analysis ; Treatment Outcome</subject><ispartof>Strahlentherapie und Onkologie, 2005-02, Vol.181 (2), p.97-107</ispartof><rights>Urban & Vogel München 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c326t-7b403fce7046694764527a230b5754149c16e888924e1bcd1b84689b6c8a59c93</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15702298$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Strege, Rainer J</creatorcontrib><creatorcontrib>Kovács, György</creatorcontrib><creatorcontrib>Maune, Steffen</creatorcontrib><creatorcontrib>Holland, Detlef</creatorcontrib><creatorcontrib>Niehoff, Peter</creatorcontrib><creatorcontrib>Eichmann, Thomas</creatorcontrib><creatorcontrib>Mehdorn, H Maximilian</creatorcontrib><title>Feasibility of combined operation and perioperative intensity-modulated brachytherapy of advanced/recurrent malignancies involving the skull base</title><title>Strahlentherapie und Onkologie</title><addtitle>Strahlenther Onkol</addtitle><description>To assess the technical feasibility and toxicity of combined operation and perioperative intensity-modulated fractionated interstitial brachytherapy (IMBT) in advanced-stage malignancies involving the skull base with the goal of preserving the patients' senses of sight.
This series consisted of 18 consecutive cases: ten patients with paranasal sinus carcinomas, five with sarcomas, two with primitive neuroectodermal tumors (PNETs), and one with parotid gland carcinoma. After, in most cases, subtotal surgical resection (R1-R2: carried out so that the patients' senses of sight were preserved), two to twelve (mean five) afterloading plastic tubes were placed into the tumor bed. IMBT was performed with an iridium-192 stepping source in pulsed-dose-rate/high-dose-rate (PDR/HDR) afterloading technique. The total IMBT dose, ranging from 10 to 30 Gy, was administered in a fractionated manner (3-5 Gy/day, 5 days/week).
Perioperative fractionated IMBT was performed in 15 out of 18 patients and was well tolerated. Complications that partially prevented or delayed IMBT in some cases included cerebrospinal fluid leakage (twice), meningitis (twice), frontal brain syndrome (twice), afterloading tube displacement (twice), seizure (once), and general morbidity (once). No surgery- or radiation-induced injuries to the cranial nerves or eyes occurred. Median survival times were 33 months after diagnosis and 16 months after combined operation and IMBT.
Perioperative fractionated IMBT after extensive but vision-preserving tumor resection seems to be a safe and well-tolerated treatment of advanced/recurrent malignancies involving the skull base. These preliminary data suggest that combined operation and perioperative fractionated IMBT is a palliative therapeutic option in the management of fatal malignancies involving the base of the skull, a strategy which leaves the patients' visual acuity intact.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Algorithms</subject><subject>Brachytherapy - adverse effects</subject><subject>Brachytherapy - methods</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Eye Injuries - etiology</subject><subject>Eye Injuries - prevention & control</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Germany - epidemiology</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - mortality</subject><subject>Neoplasm Recurrence, Local - radiotherapy</subject><subject>Neoplasm Recurrence, Local - surgery</subject><subject>Palliative Care</subject><subject>Perioperative Care - 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adverse effects</topic><topic>Brachytherapy - methods</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Eye Injuries - etiology</topic><topic>Eye Injuries - prevention & control</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Germany - epidemiology</topic><topic>Humans</topic><topic>Infant</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - mortality</topic><topic>Neoplasm Recurrence, Local - radiotherapy</topic><topic>Neoplasm Recurrence, Local - surgery</topic><topic>Palliative Care</topic><topic>Perioperative Care - adverse effects</topic><topic>Perioperative Care - methods</topic><topic>Radiation Injuries - etiology</topic><topic>Radiation Injuries - prevention & control</topic><topic>Radiation therapy</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy Planning, Computer-Assisted - methods</topic><topic>Radiotherapy, Adjuvant - adverse effects</topic><topic>Radiotherapy, Adjuvant - methods</topic><topic>Salvage Therapy - methods</topic><topic>Severity of Illness Index</topic><topic>Skull Neoplasms - mortality</topic><topic>Skull Neoplasms - radiotherapy</topic><topic>Skull Neoplasms - surgery</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Strege, Rainer J</creatorcontrib><creatorcontrib>Kovács, György</creatorcontrib><creatorcontrib>Maune, Steffen</creatorcontrib><creatorcontrib>Holland, Detlef</creatorcontrib><creatorcontrib>Niehoff, Peter</creatorcontrib><creatorcontrib>Eichmann, Thomas</creatorcontrib><creatorcontrib>Mehdorn, H Maximilian</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Strahlentherapie und Onkologie</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Strege, Rainer J</au><au>Kovács, György</au><au>Maune, Steffen</au><au>Holland, Detlef</au><au>Niehoff, Peter</au><au>Eichmann, Thomas</au><au>Mehdorn, H Maximilian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Feasibility of combined operation and perioperative intensity-modulated brachytherapy of advanced/recurrent malignancies involving the skull base</atitle><jtitle>Strahlentherapie und Onkologie</jtitle><addtitle>Strahlenther Onkol</addtitle><date>2005-02</date><risdate>2005</risdate><volume>181</volume><issue>2</issue><spage>97</spage><epage>107</epage><pages>97-107</pages><issn>0179-7158</issn><eissn>1439-099X</eissn><abstract>To assess the technical feasibility and toxicity of combined operation and perioperative intensity-modulated fractionated interstitial brachytherapy (IMBT) in advanced-stage malignancies involving the skull base with the goal of preserving the patients' senses of sight.
This series consisted of 18 consecutive cases: ten patients with paranasal sinus carcinomas, five with sarcomas, two with primitive neuroectodermal tumors (PNETs), and one with parotid gland carcinoma. After, in most cases, subtotal surgical resection (R1-R2: carried out so that the patients' senses of sight were preserved), two to twelve (mean five) afterloading plastic tubes were placed into the tumor bed. IMBT was performed with an iridium-192 stepping source in pulsed-dose-rate/high-dose-rate (PDR/HDR) afterloading technique. The total IMBT dose, ranging from 10 to 30 Gy, was administered in a fractionated manner (3-5 Gy/day, 5 days/week).
Perioperative fractionated IMBT was performed in 15 out of 18 patients and was well tolerated. Complications that partially prevented or delayed IMBT in some cases included cerebrospinal fluid leakage (twice), meningitis (twice), frontal brain syndrome (twice), afterloading tube displacement (twice), seizure (once), and general morbidity (once). No surgery- or radiation-induced injuries to the cranial nerves or eyes occurred. Median survival times were 33 months after diagnosis and 16 months after combined operation and IMBT.
Perioperative fractionated IMBT after extensive but vision-preserving tumor resection seems to be a safe and well-tolerated treatment of advanced/recurrent malignancies involving the skull base. These preliminary data suggest that combined operation and perioperative fractionated IMBT is a palliative therapeutic option in the management of fatal malignancies involving the base of the skull, a strategy which leaves the patients' visual acuity intact.</abstract><cop>Germany</cop><pub>Springer Nature B.V</pub><pmid>15702298</pmid><doi>10.1007/s00066-005-1274-1</doi><tpages>11</tpages></addata></record> |
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| subjects | Adolescent Adult Algorithms Brachytherapy - adverse effects Brachytherapy - methods Child Child, Preschool Eye Injuries - etiology Eye Injuries - prevention & control Feasibility Studies Female Germany - epidemiology Humans Infant Male Middle Aged Neoplasm Recurrence, Local - mortality Neoplasm Recurrence, Local - radiotherapy Neoplasm Recurrence, Local - surgery Palliative Care Perioperative Care - adverse effects Perioperative Care - methods Radiation Injuries - etiology Radiation Injuries - prevention & control Radiation therapy Radiotherapy Dosage Radiotherapy Planning, Computer-Assisted - methods Radiotherapy, Adjuvant - adverse effects Radiotherapy, Adjuvant - methods Salvage Therapy - methods Severity of Illness Index Skull Neoplasms - mortality Skull Neoplasms - radiotherapy Skull Neoplasms - surgery Survival Analysis Treatment Outcome |
| title | Feasibility of combined operation and perioperative intensity-modulated brachytherapy of advanced/recurrent malignancies involving the skull base |
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