Björn Sommer, Ina Konietzko, Maximilian-Niklas Bonk, Björn Hackanson, Martin Trepel, Klaus-Henning Kahl, Georg Stüben, Christoph Maurer, Ansgar Berlis, Tina Schaller, Bruno Märkl, Ehab Shiban
- Background: Tumor-treating-fields (TTF) has gained popularity as an additional therapy in patients with glioblastoma (GBM). At the same time, some patients with GBM require additional implantation of a programmable cerebrospinal fluid shunt. Data on the possible interference between both devices is scarce. The aim of this study is to investigate whether TTF may affect the shunt valves.
Methods: A retrospective analysis of all of patients with TTF Therapy between 2016 and 2020 was performed. Patients with cerebrospinal fluid (CSF) shunt systems were further analysed with regards to a valve setting alterations or malfunction.
Results: 22 consecutive patients (5 female, 17 male; age median±SD 53±16.1 yrs) where identified. Of those, 15 patients underwent surgical resection and 7 where biopsied. All patients were received adjuvant radiotherapy and temozolomide. Three patients received ventriculo-peritoneal (VP) shunts. In one patient, pressure setting of the CSF valve changedBackground: Tumor-treating-fields (TTF) has gained popularity as an additional therapy in patients with glioblastoma (GBM). At the same time, some patients with GBM require additional implantation of a programmable cerebrospinal fluid shunt. Data on the possible interference between both devices is scarce. The aim of this study is to investigate whether TTF may affect the shunt valves.
Methods: A retrospective analysis of all of patients with TTF Therapy between 2016 and 2020 was performed. Patients with cerebrospinal fluid (CSF) shunt systems were further analysed with regards to a valve setting alterations or malfunction.
Results: 22 consecutive patients (5 female, 17 male; age median±SD 53±16.1 yrs) where identified. Of those, 15 patients underwent surgical resection and 7 where biopsied. All patients were received adjuvant radiotherapy and temozolomide. Three patients received ventriculo-peritoneal (VP) shunts. In one patient, pressure setting of the CSF valve changed spontaneously and caused underdrainage during TTF treatment. Despite downregulation under fluoroscopy, hydrocephalus persisted, ultimately leading to revision surgery.
Conclusion: TTF may influence programmable values in VP-Shunt. A routine examination of the valve setting may be warranted in these patients during the TTF treatment.…
