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Evaluation of post-operative complications associated with repeat resection and BCNU wafer implantation in recurrent glioblastoma.

Abstract：

BACKGROUND:Patients with glioblastoma treated with BCNU wafer implantation for recurrence frequently receive frontline chemoradiotherapy with temozolomide as part of the Stupp protocol. A retrospective investigation was conducted of surgical complications in a cohort of these patients treated at a single institution. METHODS:We searched our institutional database for patients treated between January 2006 and October 2012 who had recurrent glioblastoma previously treated with open surgery followed by the Stupp protocol and then underwent repeat resection with or without BCNU wafers for recurrent disease. Rates of select post-operative complications within 3 months of surgery were estimated. RESULTS:We identified 95 patients with glioblastoma who underwent resection followed by the Stupp protocol as frontline treatment. At disease recurrence (first and second recurrence), 63 patients underwent repeat resection with BCNU wafer implantation and 32 without implantation. Generally, BCNU wafer use was associated with minor to moderate increases in rates of select complications versus non-implantation-wound healing abnormalities (14.2 vs. 6.2 %), cerebrospinal fluid leak (7.9 vs. 3.1 %), hydrocephalus requiring ventriculoperitoneal shunt (6.3 vs. 9.3 %), chemical meningitis (3.1 vs. 0 %), cerebral infections (3.1 vs. 0 %), cyst formation (3.1 vs. 3.1 %), cerebral edema (4.7 vs. 0 %), and empyema formations (1.5 vs. 0 %). Performance status was well maintained post-operatively in both groups. Median progression-free survival from the time of first recurrence was 6.0 and 5.0 months, respectively. CONCLUSIONS:The use of the Stupp protocol as frontline therapy in patients with glioblastoma does not preclude the use of BCNU wafers at the time of progression.

journal_name

Acta Neurochir (Wien)

journal_title

Acta neurochirurgica

authors

Samis Zella MA,Wallocha M,Slotty PJ,Isik G,Hänggi D,Schroeteler J,Ewelt C,Steiger HJ,Sabel M

doi

10.1007/s00701-013-1931-6

subject

Has Abstract

pub_date

2014-02-01 00:00:00

pages

313-23

issue

eissn

0001-6268

issn

0942-0940

journal_volume

156

pub_type

杂志文章

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Evaluation of post-operative complications associated with repeat resection and BCNU wafer implantation in recurrent glioblastoma.