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Efficacy of Whole-Ventricular Radiotherapy in Patients Undergoing Maximal Tumor Resection for Glioblastomas Involving the Ventricle

Authors
 Kyung Hwan Kim  ;  Jihwan Yoo  ;  Nalee Kim  ;  Ju Hyung Moon  ;  Hwa Kyung Byun  ;  Seok-Gu Kang  ;  Jong Hee Chang  ;  Hong In Yoon  ;  Chang-Ok Suh 
Citation
 FRONTIERS IN ONCOLOGY, Vol.11 : 736482, 2021-09 
Journal Title
FRONTIERS IN ONCOLOGY
Issue Date
2021-09
Keywords
MGMT ; glioblastoma ; radiotherapy ; temozolomide ; ventricle
Abstract
Background and purpose: Patients with glioblastoma (GBM) involving the ventricles are at high risk of ventricle opening during surgery and potential ventricular tumor spread. We evaluated the effectiveness of whole-ventricular radiotherapy (WVRT) in reducing intraventricular seeding in patients with GBM and identified patients who could benefit from this approach.

Methods and materials: We retrospectively reviewed the data of 382 patients with GBM who underwent surgical resection and temozolomide-based chemoradiotherapy. Propensity score matching was performed to compensate for imbalances in characteristics between patients who did [WVRT (+); n=59] and did not [WVRT (-); n=323] receive WVRT. Local, outfield, intraventricular, and leptomeningeal failure rates were compared.

Results: All patients in the WVRT (+) group had tumor ventricular involvement and ventricle opening during surgery. In the matched cohort, the WVRT (+) group exhibited a significantly lower 2-year intraventricular failure rate than the WVRT (-) group (2.1% vs. 11.8%; P=0.045), with no difference in other outcomes. Recursive partitioning analysis stratified the patients in the WVRT (-) group at higher intraventricular failure risk (2-year survival, 14.2%) due to tumor ventricular involvement, MGMT unmethylation, and ventricle opening. WVRT reduced the intraventricular failure rate only in high-risk patients (0% vs. 14.2%; P=0.054) or those with MGMT-unmethylated GBM in the matched cohort (0% vs. 17.3%; P=0.036).

Conclusions: WVRT reduced the intraventricular failure rate in patients with tumor ventricular involvement and ventricle opening during surgery. The MGMT-methylation status may further stratify patients who could benefit from WVRT. Further prospective evaluation of WVRT in GBM is warranted.
Files in This Item:
T202104628.pdf Download
DOI
10.3389/fonc.2021.736482
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Gu(강석구) ORCID logo https://orcid.org/0000-0001-5676-2037
Kim, Kyung Hwan(김경환)
Moon, Ju Hyung(문주형)
Byun, Hwa Kyung(변화경) ORCID logo https://orcid.org/0000-0002-8964-6275
Suh, Chang Ok(서창옥)
Yoo, Jihwan(유지환)
Yoon, Hong In(윤홍인) ORCID logo https://orcid.org/0000-0002-2106-6856
Chang, Jong Hee(장종희) ORCID logo https://orcid.org/0000-0003-1509-9800
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/186783
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