|Title:||The extent of edema and tumor synchronous invasion into the subventricular zone and corpus callosum classify outcomes and radiotherapy strategies of glioblastomas||Authors:||Liang H.-K.T.
|Issue Date:||2017||Publisher:||Elsevier Ireland Ltd||Journal Volume:||125||Journal Issue:||2||Start page/Pages:||248-257||Source:||Radiotherapy and Oncology||Abstract:||
Background and purpose Irradiating glioblastoma preoperative edema (PE) remains controversial. We investigated the associations between tumors’ PE extent with invasion into synchronous subventricular zone and corpus callosum (sSVZCC) and treatment outcomes to provide the clinical evidence for radiotherapy decision-making. Material and methods Extensive PE (EPE) was defined as PE extending ?2 cm from the tumor edge and extensive progressive disease (EPD) as tumors spreading ?2 cm from the preoperative tumor edge along PE. The survival and progression patterns were analyzed according to EPE and sSVZCC invasion. Results In total, 136 patients were followed for a median of 74.9 (range, 47.6–102.1) months. The median overall survival and progression-free survival were 19.7 versus 28.6 months (p = 0.005) and 11.0 versus 17.4 months (p = 0.011) in patients with EPE+ versus EPE?, and were 18.7 versus 25.4 months (p = 0.021) and 10.7 versus 14.6 months (p = 0.020) in those with sSVZCC+ versus sSVZCC?. The EPD rates for tumors with EPE?/sSVZCC?, EPE?/sSVZCC+, EPE+/sSVZCC?, and EPE+/sSVZCC+ were 2.8%, 7.1%, 37.0%, and 71.9%, respectively. In EPE+/sSVZCC+, tumor migration was associated with the PE extending along the corpus callosum (77.8%) and subventricular zone (50.0%). Conclusions Our results support the need for developing individualized irradiation strategies for glioblastomas according to EPE and sSVZCC. ? 2017 Elsevier B.V.
|ISSN:||0167-8140||DOI:||10.1016/j.radonc.2017.09.024||metadata.dc.subject.other:||gadolinium; temozolomide; adult; aged; Article; cancer radiotherapy; cancer survival; contrast enhancement; controlled study; corpus callosum; disease course; edema; female; follow up; glioblastoma; human; intensity modulated radiation therapy; major clinical study; male; metastasis; neuroimaging; overall survival; priority journal; progression free survival; radiation dose; subventricular zone; treatment outcome; tumor growth; tumor invasion; tumor volume; volumetric modulated arc therapy; brain tumor; corpus callosum; diagnostic imaging; disease exacerbation; disease free survival; edema; glioblastoma; lateral brain ventricle; middle aged; multiple cancer; pathology; tumor invasion; Adult; Brain Neoplasms; Corpus Callosum; Disease Progression; Disease-Free Survival; Edema; Female; Glioblastoma; Humans; Lateral Ventricles; Male; Middle Aged; Neoplasm Invasiveness; Neoplasms, Multiple Primary; Treatment Outcome
|Appears in Collections:||腫瘤醫學研究所|
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