The experience of intraoperative radiation therapy of malignant gliomas using the intrabeam system with the determination of a safely tolerated radiation dose

SUMMARY. Glioblastoma is the most malignant primary brain tumor, the gold standard of treatment for which is considered to be combination therapy, including surgical removal of the tumor followed by chemoradiotherapy. Nevertheless, the median survival of patients with this diagnosis is about 14 months. The improvement of radiation therapy has led to the possibility of its implementation during surgery, which is a practical and effective method aimed at getting rid of the remaining tumor cells, reducing the spread of glioma and filling the therapeutic gap between surgery and chemotherapy and radiation therapy.

THE PURPOSE of the study is establishing of the safety of intraoperative radiotherapy of patients with the INTRABEAM system with a dose of up to 40 Gy on the applicator.

MATERIALS AND METHODS. The study involved 15 patients the average age of which was 51 years, the ratio of men and women was 4:6, the average Karnovsky scale before surgery was 97. Next, intraoperative radiation therapy by INTRABEAM (Carl ZEISS) system with a dose of 40 Gy was performed, followed by an assessment of the Karnovsky scale, early postoperative and delayed possible complications.

RESULTS. In all patients operated on with intraoperative radiation therapy and subsequent adjuvant radiochemotherapy, the method was well tolerated, there were no wound healing features or identified complications, there were no cases of wound liquorrhea, wound inflammation.

CONCLUSION. Intraoperative radiotherapy after surgical removal of the tumor can be recommended as a safe method for the treatment of malignant gliomas in addition to existing combination therapy.

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