Journal of Neuro-Oncology

, Volume 109, Issue 1, pp 195–203 | Cite as

Can irradiation of potential cancer stem-cell niche in the subventricular zone influence survival in patients with newly diagnosed glioblastoma?

  • Tejpal Gupta
  • Vimoj Nair
  • Siji Nojin Paul
  • Sadhana Kannan
  • Aliasgar Moiyadi
  • Sridhar Epari
  • Rakesh Jalali
Clinical Study


Glioblastoma progenitor or stem cells residing in the stem-cell niche in the subventricular zones (SVZ) can initiate or promote tumorigenesis. They can also migrate throughout the brain, resulting in disease progression. Irradiation of potential cancer stem-cell niche in the SVZ may influence survival. To analyze radiotherapy dose-volume parameters to the SVZ that correlate with survival in adequately treated patients with newly diagnosed glioblastoma, 40 adults with histopathologically proven supratentorial glioblastoma with available baseline imaging treated with postoperative conventionally fractionated focal conformal radiotherapy plus chemotherapy, available radiotherapy planning dataset, and documented event of progression or death or minimum 6-month follow-up were included in this retrospective study. Dose-volume parameters to the SVZ were extracted from treatment planning system and analyzed in relation to survival outcomes. Mean ipsilateral and contralateral SVZ volumes were 5.6 and 6.4 cc, respectively. With median follow-up of 15 months (interquartile range 12–18 months), median [95 % confidence interval (CI)] progression-free survival (PFS) and overall survival (OAS) was 11 months (95 % CI 8.9–13.0 months) and 17 months (95 % CI 11.6–22.4 months), respectively. Older age (>50 years), poor recursive partitioning analysis (RPA) class, and higher than median of mean contralateral SVZ dose were associated with significantly worse PFS and OAS. Multivariate analysis identified RPA class, Karnofsky performance status, and mean ipsilateral SVZ dose as independent predictors of survival. Increasing mean dose to the ipsilateral SVZ was associated with significantly improved OAS. Irradiation of potential cancer stem-cell niche influences survival outcomes in patients with newly diagnosed glioblastoma.


Glioblastoma Radiotherapy Stem-cell niche Subventricular zone Survival 


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Copyright information

© Springer Science+Business Media, LLC. 2012

Authors and Affiliations

  • Tejpal Gupta
    • 1
  • Vimoj Nair
    • 1
  • Siji Nojin Paul
    • 1
  • Sadhana Kannan
    • 2
  • Aliasgar Moiyadi
    • 3
  • Sridhar Epari
    • 4
  • Rakesh Jalali
    • 1
  1. 1.Department of Radiation OncologyAdvanced Centre for Treatment, Research and Education in Cancer (ACTREC) and Tata Memorial Hospital, Tata Memorial CentreNavi MumbaiIndia
  2. 2.Department of Epidemiology and Clinical Trials Unit, Clinical Research SecretariatAdvanced Centre for Treatment, Research and Education in Cancer (ACTREC) and Tata Memorial Hospital, Tata Memorial CentreNavi MumbaiIndia
  3. 3.Division of Neuro-surgery, Department of Surgical OncologyAdvanced Centre for Treatment, Research and Education in Cancer (ACTREC) and Tata Memorial Hospital, Tata Memorial CentreNavi MumbaiIndia
  4. 4.Division of Neuro-pathology, Department of PathologyAdvanced Centre for Treatment, Research and Education in Cancer (ACTREC) and Tata Memorial Hospital, Tata Memorial CentreNavi MumbaiIndia

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