2588. Novel Permanently Implanted 3D-Collagen Tile for Intraoperative Brachytherapy in a Patient with Recurrent Glioblastoma

Authors: Vincent Anthony DiNapoli, MD; Yair Gozal, MD, PhD (Cincinnati, OH)

Introduction:

During resection for progressive or recurrent glioblastoma multiforme (GBM), permanent, low-activity iodine 125 seeds (half-life 60 days) have been embedded into the resection cavity. However, seed implantation can be time consuming, difficult to evenly space for precise radiation delivery, and pose risk of migration. Designed to overcome these brachytherapy shortcomings, our technical note highlights placement of a novel 3D-collagen tile embedded with a cesium-131 radiation source (half-life 10 days) in a patient with recurrent GBM.   

Methods:

Our patient previously underwent craniotomy and resection for a newly diagnosed GBM, followed by radiation and chemotherapy (Stupp Protocol). At 9-month recurrence, she underwent repeat resection of progressive tumor. This was followed by implantation of GammaTile Cesium-131brachytherapy (GT MedTech, Tempe, AZ), an FDA-approved treatment since 2019, into the resection cavity.

Results:

Pathology confirmed progressive glioblastoma. She recovered postoperatively with no complications related to the GammaTile. She continues to be followed by serial MRI and remains on maintenance chemotherapy with Temozolomide.

Conclusion:

Implantation of a multi-seed GammaTile for recurrent GBM was quick and eliminated the potential of migration in our patient. Its 3D configuration is expected to better control radiation delivery, prevent collapse of the surgical cavity around the seeds, and improve postoperative dosimetry. Additional studies underway using this implant for various types of recurrent brain tumors will further refine its applications and patient selection.