Efficacy and prognosis of surgery combined with (125)I seed implantation in treatment of recurrent glioma

This study evaluated the efficacy of surgery combined with (125)I seed implantation in the treatment of recurrent glioma, and analyzed prognosis-influencing factors. A total of 66 patients with recurrent gliomas in Yidu Central Hospital of Weifang were enrolled in the study from April, 2011 to March, 2014. Patients were randomly divided into a control and an observation group, with 33 patients in each group. Patients in the control group were treated with surgery alone, and those in the observation group received surgery combined with (125)I seed implantation. Short-term curative effects in the two groups were compared using evaluation criteria for solid tumors. The comparison included the postoperative adverse reactions, the life quality (using the Karnofsky Performance Status or KPS), the survival time and prognostic factors (using the Kaplan-Meier survival, log-rank test and Cox regression analyses). Our results showed the objective response and disease control rates in the observation group were significantly higher than those in the control group (P<0.05). While no significant differences in postoperative adverse reactions were found between the two groups (P>0.05). The KPS score in the observation group was significantly higher than that in the control group at different time points after surgery (P<0.05). The survival rate and overall survival time of those in the observation group were significantly higher than those of the patients in the control group (P<0.05). The univariate analysis showed that preoperative KPS score, tumor pathological grade and degree of tumor resection were adverse factors influencing the prognosis of the patients (P<0.05). Also, multivariate Cox regression showed that preoperative KPS score, tumor pathological grade, and degree of tumor resection were independent risk factors of prognosis. Based on our findings, surgery combined with (125)I seed implantation can improve the survival rate of patients with recurrent glioma and prolong their survival time. Tumor pathological grade, degree of tumor resection and KPS score are the most important factors influencing the prognosis.