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Patterns
of failure following treatment for glioblastoma multiforme and anaplastic
astrocytoma
Wallner KE, Galicich JH, Krol G, Arbit E, Malkin MG
Department
of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New
York 10021.
Recurrence patterns of glioblastoma multiforme (25) and anaplastic astrocytoma
(9) were studied using CT scans of 34 patients who received all or a portion of
their surgical treatment at Memorial Sloan-Kettering Cancer Center from January
1983 through February 1987.
Thirty-two patients presented with unifocal tumors and two with multifocal
tumors.
All patients received radiation therapy following initial surgery.
Eighteen patients who underwent re-operation following CT evidence of recurrence
had histologic verification of recurrent tumor; sixteen patients had
radiographic evidence of recurrence only.
Seventy-eight percent (25/32) of unifocal tumors recurred within 2.0 cm of the
pre-surgical, initial tumor margin, defined as the enhancing edge of the tumor
on CT scan.
Fifty-six percent (18/32) of tumors recurred within 1.0 cm of the initial tumor
margin.
Tumors for which a gross total resection was accomplished tended to recur closer
to the initial tumor margin than did subtotally resected tumors (p greater than
0.1).
Extensive pre-operative edema was associated with a decreased distance between
initial and recurrent tumor margins.
Large tumors were generally not more likely to recur further from the initial
tumor margin than were smaller tumors.
No unifocal tumor recurred as a multifocal tumor.
Only one tumor (initially near the midline) recurred in the contralateral
hemisphere.
The findings support the use of partial brain irradiation for post-operative
treatment of glioblastoma multiforme and anaplastic astrocytomas, and may help
to determine the most appropriate treatment volume for interstitial irradiation.
PMID: 2542195 [PubMed - indexed for MEDLINE]
Source:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2542195&dopt=Abstract
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