Author/Authors :
SEDDIGHI، Afsoun نويسنده Assistant Professor of Neurosurgery, ShohadaTajrish Hospital, Functional Neurosurgery Research Center of Shohada Tajrish Hospital, , , Esmaeil Akbari، Mohammad نويسنده Cancer Research Centre (CRC), Shahid Beheshti University
of Medical Sciences, Tehran, IR Iran , , SEDDIGHI، Amir Saied نويسنده Assistant Professor of Neurosurgery, ShohadaTajrish Hospital, Functional Neurosurgery Research Center of Shohada Tajrish Hospital, Shahid Beheshti , , Rakhsha، Afshin نويسنده , , Vaezi، Marjan نويسنده Functional Neurosurgery Research Center, Shohada Tajrish
Neurosurgical Center of Excellence, Shohada Tajrish Hospital, Shahid
Beheshti University of Medical Sciences, Tehran, IR
Iran , , Zohrevand، Amir Hossein نويسنده Functional Neurosurgery Research Center, Shohada Tajrish
Neurosurgical Center of Excellence, Shohada Tajrish Hospital, Shahid
Beheshti University of Medical Sciences, Tehran, IR
Iran ,
Abstract :
Introduction: Among the high grade cerebral gliomas, Glioblastoma multiform for instance, would be the main pattern of local recurrence causes clinical deterioration and deaths. This has observed 2 - 3 cm upon the initial lesion. During the period of 2 - 4 weeks post-surgery, remaining tumor cells have re-grown until radiochemotherapy has initiated. So it has seemed clear that improved local control could hopefully translate into improved survival. As a matter of fact, mass reduction has insufficiently achieved in almost every case of GBM as that the tumor cell number has not fallen below a “threshold” that tumor control might achieve by the host immune system.
Intraoperative Radiation therapy has been one of those add-on therapies, which has performed during or directly after resection and cleared the tumor cavity from microscopically remaining cells.
Although IORT has presented a novel and feasible principle, the method faced a number of technical and geometrical errors and limitations, which has decreased its potential in the reports of previous studies. Examples could be mentioned as incomplete target volume coverage that seemed as the greatest influence on survival, due to irradiation with an inadequate electron cone size, due to angle errors, or inadequately low energies. In contrast to the previously used forward-beaming electron cones, spherical irradiation sources were specifically attractive in brain tumor IORT, even in post resection cavities with normal complex shapes.
Case Presentation: We have been reporting 3 cases of high grade gliomas, one recurrent GBM, one primary glioma grade III, and the last one recurrent Rhabdoid GBM, which have been fulfilling our entrance criteria of IORT procedure, by using spherical applicators, which has been increasingly discussed in recent studies.
Conclusions: It was the first experience of intraoperative radiation therapy for cerebral malignant tumours in Iran. Finally, we had a brief overview on the past and present IORT strategies in the treatment of GBM.
