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

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

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.

Original languageEnglish
Article number42148
JournalScientific reports
Volume7
DOIs
Publication statusPublished - 2017 Feb 8

Bibliographical note

Funding Information:
The abstract of this study was accepted for poster viewing at the 57th Annual Meeting of the American Society for Radiation Oncology (ASTRO), San Antonio, Texas, October, 2015.

All Science Journal Classification (ASJC) codes

  • General

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