Please use this identifier to cite or link to this item: https://hdl.handle.net/1/1234
Title: Predicting patterns of failure in temporal lobe GBMs: Possible implications on radiotherapy treatment portals
Authors: Jayamanne, Dasantha ;Back, Michael F ;Wheeler, H.;Brazier, D.;Newey, A.;Kastelan, M.;Guo, L.
Affliation: Central Coast Local Health District
Gosford Hospital
Issue Date: Jul-2018
Source: 13(1):133
Journal title: Radiation Oncology
Department: Central Coast Cancer Centre
Radiation Oncology
Abstract: BACKGROUND: Characterise patterns of failure of Temporal Lobe (TL) Glioblastoma (GBM) following treatment with relation to normal temporal lobe anatomy and neural pathways. METHODS: 335 GBM patients received radiotherapy between 03/2007 and 07/2014, 100 were located in TL. Site of initial tumour and subsequent relapse were subdivided into 5 local TL sites (anterior, lateral, medial, posterior and superior); 5 adjacent regional sites (occipital lobe, inferior frontal lobe, caudate/thalamus/internal/external capsules, fornix/ventricular trigone), and 5 distant failure sites (ventricles, contralateral hemisphere, brainstem, leptomeninges and spine). Extension along major neuroanatomical pathways at initial presentation and at first documented Magnetic Resonance Imaging (MRI) failure were categorised into anterior, superior, medial and posterior pathways. RESULTS: Of the 100 patients, 86 had radiological progress with a median survival of 17.3 months. At initial diagnosis, 74% of tumours were linked to one TL site and 94% were confined to the TL. 19% had neural pathway disease at initial pre-treatment MRI. At first recurrence locoregional site failure was 74%. 26% failed within distant sites and 53% patients were noted to have neural pathway involvement. Initial tumour location predicted for local site recurrence (p < 0.0001), regional site recurrence (p = 0.004) and neural pathway recurrence pattern (p = 0.005), but not for distant sites (p = 0.081). CONCLUSION: Most GBMs fail at local or adjacent regional sites. Many of the recurrences occurred in a predictable pattern within a local or regional site, unique to initial TL site with more than half involving neural pathways. Knowledge of tumour infiltration and failure may improve target definition and radiotherapy.
URI: https://elibrary.cclhd.health.nsw.gov.au/cclhdjspui/handle/1/1234
DOI: 10.1186/s13014-018-1078-y
Pubmed: https://www.ncbi.nlm.nih.gov/pubmed/30029668
ISSN: 1748-717x
Publicaton type: Journal Article
Keywords: Radiation
Appears in Collections:Oncology / Cancer

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