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

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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

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temozolomide
Chemoradiotherapy
Glioblastoma
Edema
Radiotherapy
Necrosis
Radiation
Recurrence
Methylation
Disease-Free Survival

All Science Journal Classification (ASJC) codes

  • General

Cite this

@article{382ffcf6b8ba4877917c92cde3dbe7f5,
title = "Impact of Including Peritumoral Edema in Radiotherapy Target Volume on Patterns of Failure in Glioblastoma following Temozolomide-based Chemoradiotherapy",
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.",
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Impact of Including Peritumoral Edema in Radiotherapy Target Volume on Patterns of Failure in Glioblastoma following Temozolomide-based Chemoradiotherapy. / Choi, Seo Hee; Kim, Jun Won; Chang, Jee Suk; Cho, Jae Ho; Kim, Se Hoon; Chang, Jong Hee; Suh, Chang Ok.

In: Scientific reports, Vol. 7, 42148, 08.02.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impact of Including Peritumoral Edema in Radiotherapy Target Volume on Patterns of Failure in Glioblastoma following Temozolomide-based Chemoradiotherapy

AU - Choi, Seo Hee

AU - Kim, Jun Won

AU - Chang, Jee Suk

AU - Cho, Jae Ho

AU - Kim, Se Hoon

AU - Chang, Jong Hee

AU - Suh, Chang Ok

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