Objective:

To compare the efficacy and safety of low-dose versus high-dose iodine-125 (125I) seed implantation in patients with recurrent glioblastoma.

Approach:

• Study Design: Retrospective analysis of 62 patients with recurrent glioblastoma who underwent MR-guided 125I seed implantation.
• Patient Stratification: Patients were divided into two groups based on prescribed dose: 120–140 Gy and 140–160 Gy.
• Outcome Measures: Comparison of 6-month objective response rate (ORR), 1-year survival rate, median overall survival (OS), and complications.

Key Findings:

• 6-month ORR: 61.9% (120–140 Gy) vs. 73.2% (140–160 Gy), no significant difference (P = 0.362).
• 1-year survival rate: 42.9% (low-dose) vs. 68.3% (high-dose), approaching significance (P = 0.053).
• Median OS: 13.7 months (high-dose) vs. 11.2 months (low-dose), statistically significant (P = 0.001).
• Higher dose group had more cases of symptomatic brain edema (10 cases vs. 2 cases in low-dose group).

Interpretation:

Higher doses of 125I seed implantation may lead to improved clinical outcomes in recurrent glioblastoma, despite an increased risk of complications.

Limitations:

• Retrospective design limits causal inferences.
• Small sample size may affect the generalizability of findings.
• Findings are preliminary and require validation in prospective studies.

Conclusion:

125I seed implantation is a potential salvage treatment for recurrent glioblastoma, with higher doses associated with better outcomes but increased complications.