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

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Abstract

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.

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Authors and Affiliations

  1. Department of Radiation Oncology, Advanced Centre for Treatment, Research and Education in Cancer (ACTREC) and Tata Memorial Hospital, Tata Memorial Centre, Kharghar, Navi Mumbai, 410210, India

    Tejpal Gupta, Vimoj Nair, Siji Nojin Paul & Rakesh Jalali

  2. Department of Epidemiology and Clinical Trials Unit, Clinical Research Secretariat, Advanced Centre for Treatment, Research and Education in Cancer (ACTREC) and Tata Memorial Hospital, Tata Memorial Centre, Kharghar, Navi Mumbai, 410210, India

    Sadhana Kannan

  3. Division of Neuro-surgery, Department of Surgical Oncology, Advanced Centre for Treatment, Research and Education in Cancer (ACTREC) and Tata Memorial Hospital, Tata Memorial Centre, Kharghar, Navi Mumbai, 410210, India

    Aliasgar Moiyadi

  4. Division of Neuro-pathology, Department of Pathology, Advanced Centre for Treatment, Research and Education in Cancer (ACTREC) and Tata Memorial Hospital, Tata Memorial Centre, Kharghar, Navi Mumbai, 410210, India

    Sridhar Epari

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  1. Tejpal Gupta
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Correspondence to Tejpal Gupta.

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Gupta, T., Nair, V., Paul, S.N. et al. Can irradiation of potential cancer stem-cell niche in the subventricular zone influence survival in patients with newly diagnosed glioblastoma?. J Neurooncol 109, 195–203 (2012). https://doi.org/10.1007/s11060-012-0887-3

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  • DOI: https://doi.org/10.1007/s11060-012-0887-3

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