Abstract:
:Glioblastomas are aggressive brain tumors that frequently recur in the subventricular zone (SVZ) despite maximal treatment. The purpose of this study was to evaluate imaging patterns of subventricular progression and impact of recurrent subventricular tumor involvement and radiation dose to patient outcome. Retrospective review of 50 patients diagnosed with glioblastoma and treated with surgery, radiation, and concurrent temozolomide from January 2012 to June 2013 was performed. Tumors were classified based on location, size, and cortical and subventricular zone involvement. Survival was compared based on recurrence type, distance from the initial enhancing tumor (local ≤ 2 cm, distant > 2 cm), and the radiation dose at the recurrence site. Progression of enhancing subventricular tumor was common at both local (58%) and distant (42%) sites. Median survival was better after local SVZ recurrence than distant SVZ recurrence (8.7 vs. 4.3 months, p = 0.04). Radiation doses at local SVZ recurrence sites recurrence averaged 57.0 ± 4.0 Gy compared to 44.7 ± 6.7 Gy at distant SVZ recurrence sites (p = 0.008). Distant subventricular progression at a site receiving ≤ 45 Gy predicted worse subsequent survival (p = 0.05). Glioblastomas frequently recurred in the subventricular zone, and patient survival was worse when enhancing tumor occurred at sites that received lower radiation doses. This recurrent disease may represent disease undertreated at the time of diagnosis, and further study is needed to determine if improved treatment strategies, such as including the subventricular zone in radiation fields, could improve clinical outcomes.
journal_name
J Neurooncoljournal_title
Journal of neuro-oncologyauthors
Weinberg BD,Boreta L,Braunstein S,Cha Sdoi
10.1007/s11060-018-2822-8subject
Has Abstractpub_date
2018-07-01 00:00:00pages
549-556issue
3eissn
0167-594Xissn
1573-7373pii
10.1007/s11060-018-2822-8journal_volume
138pub_type
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pub_type: 临床试验,杂志文章
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journal_title:Journal of neuro-oncology
pub_type: 临床试验,杂志文章
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doi:10.1007/BF00172949
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章
doi:10.1007/s11060-014-1584-1
更新日期:2014-12-01 00:00:00
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journal_title:Journal of neuro-oncology
pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 杂志文章
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journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/BF00182082
更新日期:1990-02-01 00:00:00
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journal_title:Journal of neuro-oncology
pub_type: 杂志文章
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更新日期:1997-04-01 00:00:00
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pub_type: 杂志文章
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更新日期:2009-01-01 00:00:00
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