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Impact of Including Peritumoral Edema in Radiotherapy Target Volume on Patterns of Failure in Glioblastoma following Temozolomide-based Chemoradiotherapy

 Seo Hee Choi  ;  Jun Won Kim  ;  Jee Suk Chang  ;  Jae Ho Cho  ;  Se Hoon Kim  ;  Jong Hee Chang  ;  Chang-Ok Suh 
 SCIENTIFIC REPORTS, Vol.7 : 42148, 2017 
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We assessed the impact of including peritumoral edema in radiotherapy volumes on recurrence patterns among glioblastoma multiforme (GBM) patients treated with standard chemoradiotherapy (CRT). We analyzed 167 patients with histologically confirmed GBM who received temozolomide (TMZ)-based CRT between May 2006 and November 2012. The study cohort was divided into edema (+) (n = 130) and edema (-) (n = 37) groups, according to whether the entire peritumoral edema was included. At a median follow-up of 20 months (range, 2-99 months), 118 patients (71%) experienced progression/recurrence (infield: 69%; marginal: 26%; outfield: 16%; CSF seeding: 12%). The median overall survival and progression-free survival were 20 months and 15 months, respectively. The marginal failure rate was significantly greater in the edema (-) group (37% vs. 22%, p = 0.050). Among 33 patients who had a favorable prognosis (total resection and MGMT-methylation), the difference in the marginal failure rates was increased (40% vs. 14%, p = 0.138). Meanwhile, treatment of edema did not significantly increase the incidence of pseudoprogression/radiation necrosis (edema (-) 49% vs. (+) 37%, p = 0.253). Inclusion of peritumoral edema in the radiotherapy volume can reduce marginal failures following TMZ-based CRT without increasing pseudoprogression/radiation necrosis.
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1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Se Hoon(김세훈) ORCID logo https://orcid.org/0000-0001-7516-7372
Kim, Jun Won(김준원) ORCID logo https://orcid.org/0000-0003-1358-364X
Suh, Chang Ok(서창옥)
Chang, Jong Hee(장종희)
Chang, Jee Suk Paul(장지석) ORCID logo https://orcid.org/0000-0001-7685-3382
Cho, Jae Ho(조재호) ORCID logo https://orcid.org/0000-0001-9966-5157
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