Journal of Neuro-Oncology

, Volume 118, Issue 2, pp 413–419 | Cite as

Relationship between survival and increased radiation dose to subventricular zone in glioblastoma is controversial

  • Olgun Elicin
  • Ebrar Inac
  • Esengul Kocak Uzel
  • Songul Karacam
  • Omer Erol Uzel
Clinical Study

Abstract

To test the hypothesis on prolonged survival in glioblastoma cases with increased subventricular zone (SVZ) radiation dose. Sixty glioblastoma cases were previously treated with adjuvant radiotherapy and Temozolamide. Ipsilateral, contralateral and bilateral SVZs were contoured and their doses were retrospectively evaluated. Median follow-up, progression free survival (PFS) and overall survival (OS) were 24.5, 8.5 and 19.3 months respectively. Log-rank tests showed a statistically significant correlation between contralateral SVZ (cSVZ) dose > 59.2 Gy (75th percentile) and poor median PFS (10.37 [95 % CI 8.37–13.53] vs 7.1 [95 % CI 3.5–8.97] months, p = 0.009). cSVZ dose > 59.2 Gy was associated with poor OS in the subgroup with subtotal resection/biopsy (HR: 4.83 [95 % CI 1.71–13.97], p = 0.004). High ipsilateral SVZ dose of > 62.25 Gy (75th percentile) was associated with poor PFS in both subgroups of high performance status (HR: 2.58 [95 % CI 1.03–6.05], p = 0.044) and SVZ without tumoral contact (HR: 10.57 [95 % CI 2.04–49], p = 0.008). The effect of high cSVZ dose on PFS lost its statistical significance in multivariate Cox regression analysis. We report contradictory results compared to previous publications. Changing the clinical practice based on retrospective studies which even do not indicate consistent results among each other will be dangerous. We need carefully designed prospective randomized studies to evaluate any impact of radiation to SVZ in glioblastoma.

Keywords

Glioblastoma Radiotherapy Radiation Subventricular zone Survival Dose 

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Olgun Elicin
    • 1
    • 2
  • Ebrar Inac
    • 1
  • Esengul Kocak Uzel
    • 3
  • Songul Karacam
    • 1
  • Omer Erol Uzel
    • 1
  1. 1.Radiation Oncology Department, Cerrahpasa Faculty of MedicineIstanbul UniversityIstanbulTurkey
  2. 2.Inselspital, Radiation Oncology DepartmentUniversity of BernBernSwitzerland
  3. 3.Radiation Oncology DepartmentSisli Etfal Teaching HospitalIstanbulTurkey

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