Abstract Details

Title Piedmont Brain Tumor Center’s Experience with GammaTile Intracranial Brachytherapy for Malignant Intracranial Tumors

Topic Neuro-oncology

Presentation(s) P6 - Poster Session 6 (5:30 PM-6:30 PM)

Poster/Presentation
Number 4-006

Background Standard of care for malignant intracranial tumors involves maximal safe surgical resection, followed by external beam radiation (EBRT) +/- chemotherapy. However, standard post-operative EBRT has been limited by uneven dose distribution, complicated workflow, extended procedural times, equipment costs, frequent adverse events (AEs), and time-delays limiting adjunctive therapies.

Objective Describe the real-world experience a high-volume community-based referral hospital in metropolitan Atlanta with Surgically Targeted Radiation Therapy (START) which involves implanting Cesium-131 seeds into the tumor cavity following resection of new and recurrent malignant intracranial tumors.

Design/Methods Between January 2020 and September 2021, a total of 17 patients, with a total of 19 lesions, were treated. A craniotomy for maximal safe resection was performed for each lesion with near or gross-total resection followed by implantation with cesium-131 GammaTile brachytherapy. Clinical and patient-reported outcomes are collected, including demographics, pathology, AEs, quality of life, feasibility, economics, length-of-stay, local control (LC) and/or distant recurrence, overall survival (OS).

Results By submission, we've treated 8 patients with brain metastases (BM) with 10 total lesions, 7 with recurrent glioblastoma (GBM), and 2 with recurrent malignant meningiomas (MM). For each group, LC and OS were as follows: BM was 10.2 months and 12 months; GBM was 5.6 months and 7 months; MM was 6 months and 7.5 months, respectively. One case of radiation necrosis was noted in the MM group at 5.6 months following a heavily pre-treated patient with previous EBRT. No other surgical complications were noted. To-date, it appears feasible and similar peri-op/post-op neurologic events, length-of-stay, as compared to historical controls.

Conclusions GammaTile brachytherapy facilitates two therapies at the time of resection for new and recurrent intracranial neoplasms. Our to-date real-world experience supports it being a safe, feasible, and effective therapy for surgical candidates. Our evolving results aim to contribute to future trial design and optimal sequencing of GammaTile.

Authors/Disclosures
Erin M. Dunbar, MD (Piedmont Physicians Neuro-Oncology) PRESENTER	Dr. Dunbar has nothing to disclose.
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