https://scholars.lib.ntu.edu.tw/handle/123456789/599047
標題: | Peritumoral edema status of glioblastoma identifies patients reaching long-term disease control with specific progression patterns after tumor resection and high-dose proton boost | 作者: | Liang H.-K.T HSIANG-KUANG LIANG |
關鍵字: | Dose-escalated radiotherapy;Glioblastoma;Imaging biomarker;Peritumoral edema;Personalized treatment;Proton beam therapy;bevacizumab;corticosteroid;gadolinium chelate;nimustine;temozolomide;adult;age;aged;Article;brain edema;cancer control;cancer growth;cancer patient;cancer surgery;cancer survival;chemoradiotherapy;clinical article;distant metastasis;edema;female;follow up;glioblastoma;headache;high dose proton boost;human;human tissue;male;median survival time;multiple cycle treatment;neuroimaging;nuclear magnetic resonance imaging;overall survival;peritumoral edema;preoperative period;progression free survival;proton therapy;radiation necrosis;radiotherapy dosage;retrospective study;seizure;treatment response;tumor volume;brain tumor;disease exacerbation;middle aged;neurosurgery;pathology;treatment outcome;very elderly;Adult;Aged;Aged, 80 and over;Brain Edema;Brain Neoplasms;Disease Progression;Female;Humans;Male;Middle Aged;Neurosurgical Procedures;Proton Therapy;Retrospective Studies;Treatment Outcome | 公開日期: | 2021 | 卷: | 147 | 期: | 12 | 起(迄)頁: | 3503-3516 | 來源出版物: | Journal of Cancer Research and Clinical Oncology | 摘要: | Background: Glioblastoma peritumoral edema (PE) extent is associated with survival and progression pattern after tumor resection and radiotherapy (RT). To increase tumor control, proton beam was adopted to give high-dose boost (> 90?Gy). However, the correlation between PE extent and prognosis of glioblastoma after postoperative high-dose proton boost (HDPB) therapy stays unknown. We intend to utilize the PE status to classify the survival and progression patterns. Methods: Patients receiving HDPB (96.6 GyE) were retrospectively evaluated. Limited peritumoral edema (LPE) was defined as PE extent < 3?cm with a ratio of PE extent to tumor maximum diameter of < 0.75. Extended progressive disease (EPD) was defined as progression of tumors extending > 1?cm from the tumor bed edge. Results: After long-term follow-up (median 88.7, range 63.6–113.8?months) for surviving patients with (n = 13) and without (n = 32) LPE, the median overall survival (OS) and progression-free survival (PFS) were 77.2 vs. 16.7?months (p = 0.004) and 13.6 vs. 8.6?months (p = 0.02), respectively. In multivariate analyses combined with factors of performance, age, tumor maximum diameter, and tumor resection extent, LPE remained a significant factor for favorable OS and PFS. The rates of 5-year complete response, EPD, and distant metastasis with and without LPE were 38.5% vs. 3.2% (p = 0.005), 7.7% vs. 40.6% (p = 0.04), and 0% vs. 34.4% (p = 0.02), respectively. Conclusions: The LPE status effectively identified patients with relative long-term control and specific progression patterns after postoperative HDPB for glioblastoma. ? 2021, The Author(s). |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85113881653&doi=10.1007%2fs00432-021-03765-6&partnerID=40&md5=0f832724f321729a7961cfa14efa8c8d https://scholars.lib.ntu.edu.tw/handle/123456789/599047 |
ISSN: | 01715216 | DOI: | 10.1007/s00432-021-03765-6 |
顯示於: | 醫學工程學研究所 |
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