Adverse prognosis and distinct progression patterns after concurrent chemoradiotherapy for glioblastoma with synchronous subventricular zone and corpus callosum invasion

Tony Hsiang-Kuang Liang; Sung-Hsin Kuo; Chun-Wei Wang; Wan-Yu Chen; Che-Yu Hsu; Shih-Fan Lai; Ham-Min Tseng; San-Lin You; Chung-Ming Chen; Wen-Yih Isaac Tseng

doi:10.1016/j.radonc.2015.11.017

Adverse prognosis and distinct progression patterns after concurrent chemoradiotherapy for glioblastoma with synchronous subventricular zone and corpus callosum invasion

Radiother Oncol. 2016 Jan;118(1):16-23. doi: 10.1016/j.radonc.2015.11.017. Epub 2015 Dec 8.

Authors

Affiliations

¹ Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan; Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Radiation Science and Proton Therapy Center, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Neurology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
² Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Radiation Science and Proton Therapy Center, National Taiwan University College of Medicine, Taipei, Taiwan; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan.
³ Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Radiation Science and Proton Therapy Center, National Taiwan University College of Medicine, Taipei, Taiwan.
⁴ Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
⁵ Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan; Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
⁶ Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
⁷ Department of Public Health, College of Medicine and Big Data Research Centre, Fu-Jen Catholic University, New Taipei City, Taiwan.
⁸ Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan.
⁹ Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Medical Imaging, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: wytseng@ntu.edu.tw.

PMID: 26678342
DOI: 10.1016/j.radonc.2015.11.017

Abstract

Background and purpose: The subventricular zone (SVZ) and the corpus callosum (CC) invasion status are separately associated with adverse prognosis for glioblastoma. We investigated the prognosis and progression patterns of glioblastoma with and without synchronous SVZ and CC (sSVZCC) invasion.

Material and methods: Glioblastoma patients completing concurrent chemoradiotherapy with temozolomide were retrospectively categorized by the preoperative sSVZCC invasion status. The associations between sSVZCC invasion and the survival and progression patterns were analyzed.

Results: In total, 108 patients, including 36 with sSVZCC invasion, were followed for a median period of 60.2 (range 34.2-86.3) months. The median overall survival (OS) of patients with and without sSVZCC were 18.6 and 26.4 months, respectively (p=0.005). Using multivariate analyses with the factors of age, performance, surgery extent, and tumor size, sSVZCC invasion remained significant for a poor OS (hazard ratio, 1.96; 95% confidence interval, 1.19-3.21). The rates of progression at tumor bed, preoperative edematous areas, bilateral hemispheres, and ventricles for tumors with and without sSVZCC invasion were 75% and 63.9% (p=0.282), 41.7% and 9.7% (p<0.001), 47.2% and 13.9% (p<0.001), and 38.9% and 13.9% (p=0.006), respectively.

Conclusions: The sSVZCC invasion status determined the distinct prognosis and progression areas of glioblastoma, which suggests individualized radiotherapy and drug administration strategies.

Keywords: Anatomical prognostic factor; Corpus callosum; Glioblastoma; Progression patterns and sites; Subventricular zone.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aged, 80 and over
Brain Neoplasms / diagnostic imaging
Brain Neoplasms / pathology
Brain Neoplasms / therapy*
Cerebral Ventricles / pathology*
Cerebral Ventriculography
Chemoradiotherapy*
Corpus Callosum / diagnostic imaging
Corpus Callosum / pathology*
Disease Progression*
Female
Glioblastoma / diagnostic imaging
Glioblastoma / pathology
Glioblastoma / therapy*
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Neoplasm Invasiveness
Prognosis
Proportional Hazards Models
Retrospective Studies
Tomography, X-Ray Computed
Young Adult