Brachytherapy is the implantation of radioactive isotopes into a tumor. This method delivers a high dose of radiation to the tumor while sparing most of the surrounding normal tissue. It may be a good choice for patients with poor health, advanced age, or unresectable or recurrent tumors. The most commonly used brachy-therapy method for treating meningiomas is permanent implantation of I-125 seeds. These seeds deliver high levels of radiation for a period of months, which is a potential advantage for treating slow-growing tumors like menin-giomas. The seeds can be placed stereotactically or directly sewed or glued into the tumor cavity.
The clinical results of brachytherapy for meningiomas are limited. Patil et al. reported on 26 patients with meningiomas undergoing I-125 seed implant . All 26 patients experienced tumor regression. The authors have treated 14 patients with intracranial meningiomas at the Cleveland Clinic using stereotactic wand guidance. One to five I-125 seeds were placed in each tumor to provide a minimum peripheral dose of 10,000 centigray (cGy) total decay. Overall, the procedure has been well tolerated with encouraging initial results. However, the interest in using brachytherapy as a treatment for meningiomas has waned given the development of radiosurgical and conformal radiation techniques.
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