{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T04:19:53Z","timestamp":1749097193974,"version":"3.41.0"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T00:00:00Z","timestamp":1744070400000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg Rep"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Glioblastoma multiforme (GBM), despite aggressive multimodal treatment comprising surgery followed by chemoradiation, is almost uniformly associated with inevitable recurrence and poor outcomes. In this clinical context, local radiation therapy\u2014an emerging approach\u2014has gained considerable attention over time for its potential to address the limitations of traditional treatment options for GBM. Multiple surgeries and adjuvant chemoradiation therapy can negatively impact the integrity of the scalp soft tissues and can compromise the ability to achieve primary closure over the surgical site. In these circumstances, complex reconstruction with free tissue transfer may be necessary.<\/jats:p><jats:p>We report the case of a 37-year-old female patient with recurrent GBM and associated wound healing complications who underwent single-stage GammaTile surgically targeted radiation therapy combined with microvascular free flap scalp reconstruction.<\/jats:p><jats:p>Immediate free flap reconstruction over the site of GammaTile implantation did not result in any wound healing complications and did not compromise the viability of the transplanted tissue. This approach also provided immediate and localized radiation, possibly enhancing patient progression-free survival while reducing the likelihood of radiation-induced adverse effects.<\/jats:p><jats:p>We report the first case of GammaTile implantation with immediate reconstruction of the overlaying soft tissue defect with a free flap. Despite the immediate local radiation produced by the tiles abutting the deep surface of the free flap, there were no complications noted in the vascularity of the transplanted tissue. This finding provides preliminary evidence supporting the safety of using free tissue transfer alongside GammaTile implantation for complex reconstruction.<\/jats:p>","DOI":"10.1055\/a-2576-7559","type":"journal-article","created":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T00:11:36Z","timestamp":1744157496000},"page":"e92-e97","source":"Crossref","is-referenced-by-count":0,"title":["Recurrent Glioblastoma Resection with Microvascular Free Flap Reconstruction and Associated GammaTile Implantation: A Personalized Approach with Oncologic and Reconstructive Integration"],"prefix":"10.1055","volume":"86","author":[{"given":"Russel T.","family":"Wagner","sequence":"additional","affiliation":[{"name":"Intent Medical Group, Endeavor Health Advanced Neurosciences Institute, Northwest Community Hospital, Arlington Heights, Illinois, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacopo","family":"Berardinelli","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Neuroscience, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Napoli, Campania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amin B.","family":"Kassam","sequence":"additional","affiliation":[{"name":"Intent Medical Group, Endeavor Health Advanced Neurosciences Institute, Northwest Community Hospital, Arlington Heights, Illinois, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julian E.","family":"Bailes","sequence":"additional","affiliation":[{"name":"Endeavor Health Neurosciences, NorthShore Neurological Institute, Evanston, Illinois, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melanie B.","family":"Fukui","sequence":"additional","affiliation":[{"name":"Intent Medical Group, Endeavor Health Advanced Neurosciences Institute, Northwest Community Hospital, Arlington Heights, Illinois, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George C.","family":"Bobustuc","sequence":"additional","affiliation":[{"name":"Intent Medical Group, Endeavor Health Advanced Neurosciences Institute, Northwest Community Hospital, Arlington Heights, Illinois, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sammy","family":"Khalili","sequence":"additional","affiliation":[{"name":"Intent Medical Group, Endeavor Health Advanced Neurosciences Institute, Northwest Community Hospital, Arlington Heights, Illinois, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil S.","family":"Mundi","sequence":"additional","affiliation":[{"name":"Intent Medical Group, Endeavor Health Advanced Neurosciences Institute, Northwest Community Hospital, Arlington Heights, Illinois, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,4,25]]},"reference":[{"issue":"30","key":"ref1","doi-asserted-by":"crossref","first-page":"2445","DOI":"10.2217\/fon-2020-0558","article-title":"GammaTile: surgically targeted radiation therapy for glioblastomas","volume":"16","author":"D J Gessler","year":"2020","journal-title":"Future Oncol"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1016\/j.brachy.2021.08.011","article-title":"Safety and efficacy of GammaTile intracranial brachytherapy implanted during awake craniotomy","volume":"20","author":"S McClelland","year":"2021","journal-title":"Brachytherapy"},{"issue":"10","key":"ref3","first-page":"e29970","article-title":"GammaTile: comprehensive review of a novel radioactive intraoperative seed-loading device for the treatment of brain tumors","volume":"14","author":"C Ekhator","year":"2022","journal-title":"Cureus"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1007\/s11060-023-04523-z","article-title":"The role of GammaTile in the treatment of brain tumors: a technical and clinical overview","volume":"166","author":"M A Garcia","year":"2024","journal-title":"J Neurooncol"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.ijrobp.2021.05.001","article-title":"Dose escalated radiation therapy for glioblastoma multiforme: an international systematic review and meta-analysis of 22 prospective trials","volume":"111","author":"R Singh","year":"2021","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"06","key":"ref6","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/0007-1226(93)90227-3","article-title":"Early postoperative brachytherapy following free flap reconstruction","volume":"46","author":"J I Panchal","year":"1993","journal-title":"Br J Plast Surg"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1007\/s12262-020-02398-2","article-title":"Is brachytherapy feasible after head and neck cancer reconstructive surgery? 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