Nuklearmedizin 2021; 60(04): 283-288
DOI: 10.1055/a-1429-1967
Original Article

Intracranial 131I-chTNT Brachytherapy in Patients with Deep-Seated Glioma: A Single-center Experience with 10-Year Follow-up from China

Intrakranielle 131I-chTNT-Brachytherapie bei Patienten mit tiefsitzendem Gliom: Erfahrung eines Zentrums in China mit Follow-up über 10 Jahre
Ming Zhao
Department of Neurosurgery, Fourth Medical Center, Chinese PLA General Hospital, Beijing, China
Xiangping Fu
Department of Neurosurgery, Fourth Medical Center, Chinese PLA General Hospital, Beijing, China
Zhiwen Zhang
Department of Neurosurgery, Fourth Medical Center, Chinese PLA General Hospital, Beijing, China
Anmin Li
Department of Neurosurgery, Fourth Medical Center, Chinese PLA General Hospital, Beijing, China
Xiaopeng Wang
Department of Neurosurgery, Fourth Medical Center, Chinese PLA General Hospital, Beijing, China
Xuexiu Li
Department of Neurosurgery, Fourth Medical Center, Chinese PLA General Hospital, Beijing, China
› Author Affiliations


Objective The intracranial brachytherapy has been applied for decades, however, no results with long-term follow-up have been reported. This study investigated the long-term efficiency of intra-tumoral injection of 131I-chTNT in patients with deep-seated glioma.

Method Thirty-five patients undergoing 131I-chTNT brachytherapy between December 2004 and May 2009 were enrolled. 131I-chTNT was injected at a dose of 1.5 mCi/cm3 at an interval of 1 month for consecutive 3 times. Serial ECT scan and MRI were performed during follow-up. Progression-free survival (PFS) and overall survival (OS) were analyzed. Adverse reactions were graded with WHO Toxicity Grading Scale for determining the severity of adverse events.

Results ECT scan showed that enhanced accumulation of radioactive agents in the tumor lasted for more than 30 days. Three months after final injection, tumor complete remission (CR) was observed in 4 patients (11.4 %), partial remission (PR) in 11 cases (31.4 %), stable disease (SD) in 10 cases (28.6 %) and progressive disease (PD) in 10 cases (28.6 %). At 6-month, CR, PR, SD and PD were 2, 6, 12 and 15 respectively. After 10 years of follow-up, median progression-free survival (PFS) and overall survival (OS) were 5.4 and 11.4 months. One-year survival was 45.7 %, two and five-year survival was 8.6 %, ten-year survival was 5.7 %. Multivariate analysis showed that pathological grade and tumor diameter were independent prognostic factors for PFS and OS. Grade I–II adverse events occurred after drug injection, including nausea, fever, headache, hairloss and fatigue.

Conclusion131I-chTNT intracranial brachytherapy is efficient and safe for patients with deep-seated glioma. It is a reliable option for inoperable glioma patients.


Ziel Die intrakranielle Brachytherapie wird seit Jahrzehnten angewandt, jedoch wurden bisher keine Ergebnisse mit Langzeit-Follow-up berichtet. Diese Studie untersuchte die langfristige Effizienz der intratumoralen Injektion von 131I-chTNT bei Patienten mit tiefsitzendem Gliom.

Methode 35 Patienten, die sich zwischen Dezember 2004 und Mai 2009 einer 131I-chTNT-Brachytherapie unterzogen, wurden eingeschlossen. 131I-chTNT wurde mit einer Dosis von 1,5mCi/cm3 in 1-monatlichem Abstand 3-mal hintereinander injiziert. Im Follow-up wurden serielle ECT-Scans und MRTs durchgeführt. Das progressionsfreie Überleben (PFS) und das Gesamtüberleben (OS) wurden analysiert. Nebenwirkungen wurden mit den WHO-Toxizitätskriterien (WHO Toxicity Grading Scale) bewertet, um ihren Schweregrad zu bestimmen.

Ergebnisse Der ECT-Scan zeigte, dass die verstärkte Anreicherung radioaktiver Substanzen im Tumor mehr als 30 Tage anhielt. Drei Monate nach der letzten Injektion wurde bei 4 Patienten (11,4 %) eine komplette Tumorremission (CR), in 11 Fällen (31,4 %) eine partielle Remission (PR), in 10 Fällen (28,6 %) eine stabile Erkrankung (SD) und in 10 Fällen (28,6 %) eine progressive Erkrankung (PD) beobachtet. Nach 6 Monaten betrug die Fallzahl 2 für CR, 6 für PR, 12 für SD und 15 für PD. Nach 10-jährigem Follow-up betrug das mediane progressionsfreie Überleben (PFS) 5,4 Monate und das Gesamtüberleben (OS) 11,4 Monate. Die 1-Jahres-Überlebensrate lag bei 45,7 %, die 2- und 5-Jahres-Überlebensrate bei 8,6 %, die 10-Jahres-Überlebensrate bei 5,7 %. Multivariate Analysen zeigten, dass der pathologische Grad und der Tumordurchmesser unabhängige prognostische Faktoren für PFS und OS waren. Nebenwirkungen vom Grad I–II traten nach der Injektion des Arzneimittels auf, einschließlich Übelkeit, Fieber, Kopfschmerzen, Haarausfall und Müdigkeit.

Schlussfolgerung Die intrakranielle Brachytherapie mit 131I-chTNT ist effizient und sicher für Patienten mit tiefsitzendem Gliom. Sie ist eine zuverlässige Option für Patienten mit inoperablem Gliom.

Publication History

Received: 08 December 2020

Accepted: 11 March 2021

Article published online:
09 April 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
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