Immuno-targeted brachytherapy for recurrent cerebral glioma

Objective To study the clinical outcome and adverse effects of immuno-targeted brachytherapy（ITB） with 131I-chTNT on recurrent malignant cerebral glioma. Methods Clinical data about 71 patients with recurrent malignant cerebral glioma who received ITB with 131I-chTNT in a phase-II and III clinical trial from September 2001 to March 2003 were summarized.Correlation between different drug administration methods,including intrathecal injection（group 1）,transfemoral artery-internal carotid artery delivery through ICA/（group 2）,postoperative intra-tumor local delivery（group 3） and the clinical outcome of glioma was observed. Results The clinical outcomes of glioma patients were assessed according to the WHO solid tumor scales.CR,PR,SD and PD were found in 0（0%）,1（12.5%）,2（25.0%） and 5（62.5%） out of the 8 patients in group 1,in 1（14.3%）,2（28.6%）,2（28.6%） and 2（28.6%） out of the 7 patients in group 2,in 21（37.5%）,24（42.8%）,7（12.5%） and 4（7.1%） out of the 53 patients in group 3.The patients（5.3%） in group 3 were still alive during the 7-year follow-up period after the trial and MRI showed that they were completely cured. Conclusion If the effect and adverse effect of the 3 drug delivery methods are compared,intrathecal injection of drugs is found in fact to be a subarchnoid brachytherapy during which radioactive agents cannot enter the tumor,trans-cerebral drug delivery is a brachytherapy through tumor blood vessel bed,and intra-tumor brachytherapy is a zero-distance radiotherapy which can achieve a good outcome of glioma with mild toxic and adverse effects,and is thus used as a standard clinical therapy for glioma.