Patterns of failure for glioblastoma multiforme following limited-margin radiation and concurrent temozolomide

Radiation Oncology

John B Fiveash¹  James M Markert¹  Asim K Bag¹  William H Ennis¹  Michael C Dobelbower¹  Brian J Gebhardt² 

[1] University of Alabama at Birmingham, 1700 6th Ave. South, Birmingham, AL 35233, USA;University of Texas Southwestern-Austin, 601 E. 15th St, Austin, TX 78701, USA

关键词: Patterns of failure;    Margin;    Radiotherapy;    Glioblastoma;   

Others  :  801353
DOI  :  10.1186/1748-717X-9-130

 received in 2014-03-20, accepted in 2014-05-29,  发布年份 2014

【 摘 要 】

Background

To analyze patterns of failure in patients with glioblastoma multiforme (GBM) treated with limited-margin radiation therapy and concurrent temozolomide. We hypothesize that patients treated with margins in accordance with Adult Brain Tumor Consortium guidelines (ABTC) will demonstrate patterns of failure consistent with previous series of patients treated with 2–3 cm margins.

Methods

A retrospective review was performed of patients treated at the University of Alabama at Birmingham for GBM between 2000 and 2011. Ninety-five patients with biopsy-proven disease and documented disease progression after treatment were analyzed. The initial planning target volume includes the T1-enhancing tumor and surrounding edema plus a 1 cm margin. The boost planning target volume includes the T1-enhancing tumor plus a 1 cm margin. The tumors were classified as in-field, marginal, or distant if greater than 80%, 20-80%, or less than 20% of the recurrent volume fell within the 95% isodose line, respectively.

Results

The median progression-free survival from the time of diagnosis to documented failure was 8 months (range 3–46). Of the 95 documented recurrences, 77 patients (81%) had an in-field component of treatment failure, 6 (6%) had a marginal component, and 27 (28%) had a distant component. Sixty-three patients (66%) demonstrated in-field only recurrence.

Conclusions

The low rate of marginal recurrence suggests that wider margins would have little impact on the pattern of failure, validating the use of limited margins in accordance ABTC guidelines.

【 授权许可】

   
2014 Gebhardt et al.; licensee BioMed Central Ltd.

【 图 表 】

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