Journal ArticleDOI
Bihemispheric malignant glioma: one size does not fit all.
TLDR
Recurrence of malignant glioma following radiotherapy most commonly occurs in close proximity to the original contrast enhancing CT/MRI tumor volume, so focal radiotherapy fields designed to cover the preoperative tumor contrast enhancing volume ± surrounding edema with a 2–4 centimetre margin are preferred.Abstract:
Recurrence of malignant glioma following radiotherapy most commonly occurs in close proximity to the original contrast enhancing CT/MRI tumor volume. For this reason current radiation planning favors focal radiotherapy fields designed to cover the preoperative tumor contrast enhancing volume ± surrounding edema with a 2–4 centimetre margin. Two patients with bifrontal malignant gliomas treated with such radiotherapy fields experienced out of field tumor progression while on treatment. Posterior extension along the corpus callosum, not evident on pretreatment imaging, was hypothesized as the cause of the geographic miss. The literature documenting recurrence patterns of malignant glioma following radiotherapy support focal field radiotherapy fields for most patients with malignant glioma. Reporting bias may exist in the literature, however, due to the whole brain radiotherapy used in older series reporting recurrence patterns and exclusion of patients with bihemispheric or more locally extensive tumors in more modern series. Tumor location and pattern of growth at presentation may be important factors in predicting patterns of spread and relapse after radiotherapy.read more
Citations
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Reirradiation of recurrent high-grade gliomas using amino acid PET (SPECT)/CT/MRI image fusion to determine gross tumor volume for stereotactic fractionated radiotherapy.
Anca L. Grosu,Wolfgang A. Weber,Martina Franz,Sibylle Stärk,Morand Piert,Reinhard Thamm,Hartmut Gumprecht,Markus Schwaiger,Michael Molls,Carsten Nieder +9 more
TL;DR: This first study of biologic imaging optimized SFRT plus temozolomide in recurrent high-grade gliomas demonstrates the feasibility and safety of this approach and confirms a significant survival benefit from multimodal treatment.
Journal ArticleDOI
Recurrent glioblastoma multiforme: a review of natural history and management options
TL;DR: Although recurrent GBM remains a fatal disease, the literature suggests that a subset of patients may benefit from maximal treatment efforts, and further research effort in all aspects of GBM diagnosis and treatment remains essential to improve the overall prognosis of this disease.
Journal ArticleDOI
A comparison of treatment results for recurrent malignant gliomas
TL;DR: This review compares studies of several retreatment strategies (published between 1987 and 2000) based on the quality of their evidence and suggests single-agent chemotherapy (temozolomide, nitrosoureas, platinum and taxane derivatives) may offer a better therapeutic ratio than polychemotherapy.
Journal ArticleDOI
Computerized tomographic and pathologic studies of the untreated, quiescent and recurrent glioblastoma multiforme
Journal ArticleDOI
Effects of Radiation on a Model of Malignant Glioma Invasion
Glenn Bauman,Warren MacDonald,Emi Moore,David A. Ramsey,Barbara Fisher,Verena R. Amberger,Rolando M. Del Maestro,Rolando M. Del Maestro +7 more
TL;DR: Responses to radiation treatment for four malignant glioma cell lines and nine primary human glioblastoma explants were characterized and addition of BCNU and dexamethasone to radiation produced additional inhibition of invasion among the cell Lines and explants but could not suppress invasion entirely.
References
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Journal ArticleDOI
Assumptions in the radiotherapy of glioblastoma
Fred H. Hochberg,Amy A. Pruitt +1 more
TL;DR: CT scan accuracy may permit smaller-field and higher-dose irradiation therapy for glioblastoma, and current radiation doses would appear to be inadequate for therapy of the primary tumor.
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Imaging-based stereotaxic serial biopsies in untreated intracranial glial neoplasms
Patrick J. Kelly,Catherine Daumas-Duport,David B. Kispert,Bruce A. Kall,Bernd W. Scheithauer,Joseph J. Illig +5 more
TL;DR: Histological analysis of 195 biopsy specimens obtained from various locations within the volumes defined by CT and MRI revealed that contrast enhancement most often corresponded to tumor tissue without intervening parenchyma, and isolated tumor cell infiltration extended at least as far as T2 prolongation on magnetic resonance images.
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Patterns of Failure Following Treatment for Glioblastoma Multiforme and Anaplastic Astrocytoma
TL;DR: 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.
Journal ArticleDOI
Topographic anatomy and CT correlations in the untreated glioblastoma multiforme.
TL;DR: The distribution of cells of a GBM cannot be inferred from CT images since the "peritumoral" area of low density can over- or underestimate the extent of the lesion, and this suggests that glioblastomas will be difficult to treat successfully by intra-arterial therapy using existing therapeutic agents.
Journal ArticleDOI
Stereotactic Histologic Correlations of Computed Tomography- and Magnetic Resonance Imaging-Defined Abnormalities in Patients With Glial Neoplasms
Patrick J. Kelly,Catherine Daumas-Duport,Bernd W. Scheithauer,Bruce A. Kall,David B. Kispert +4 more
TL;DR: In this paper, CT and MRI detection of boundaries and stereotactic serial biopsies are necessary for the demarcation of glial neoplasms into tumor tissue and isolated tumor cell volumes as well as for the determination of the spatial extent of each component.