Pattern of Recurrence of Glioblastoma Versus Grade 4 IDH-Mutant Astrocytoma Following Chemoradiation: A Retrospective Matched-Cohort Analysis

Autor: James Stewart PhD, Arjun Sahgal MD, Aimee K M Chan MSc, Hany Soliman MD, Chia-Lin Tseng MD, Jay Detsky MD, PhD, Sten Myrehaug MD, Eshetu G Atenafu MSc, Ali Helmi MD, James Perry MD, Julia Keith MD, Mary Jane Lim-Fat MD, MSc, David G Munoz MD, MSc, Gelareh Zadeh MD, PhD, David B Shultz MD, PhD, Sunit Das MD, PhD, Catherine Coolens PhD, Paula Alcaide-Leon MD, Pejman Jabehdar Maralani MD
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Technology in Cancer Research & Treatment, Vol 21 (2022)
Druh dokumentu: article
ISSN: 1533-0338
15330338
DOI: 10.1177/15330338221109650
Popis: Background and Purpose: To quantitatively compare the recurrence patterns of glioblastoma (isocitrate dehydrogenase-wild type) versus grade 4 isocitrate dehydrogenase-mutant astrocytoma (wild type isocitrate dehydrogenase and mutant isocitrate dehydrogenase, respectively) following primary chemoradiation. Materials and Methods: A retrospective matched cohort of 22 wild type isocitrate dehydrogenase and 22 mutant isocitrate dehydrogenase patients were matched by sex, extent of resection, and corpus callosum involvement. The recurrent gross tumor volume was compared to the original gross tumor volume and clinical target volume contours from radiotherapy planning. Failure patterns were quantified by the incidence and volume of the recurrent gross tumor volume outside the gross tumor volume and clinical target volume, and positional differences of the recurrent gross tumor volume centroid from the gross tumor volume and clinical target volume. Results: The gross tumor volume was smaller for wild type isocitrate dehydrogenase patients compared to the mutant isocitrate dehydrogenase cohort (mean ± SD: 46.5 ± 26.0 cm 3 vs 72.2 ± 45.4 cm 3 , P = .026). The recurrent gross tumor volume was 10.7 ± 26.9 cm 3 and 46.9 ± 55.0 cm 3 smaller than the gross tumor volume for the same groups ( P = .018). The recurrent gross tumor volume extended outside the gross tumor volume in 22 (100%) and 15 (68%) ( P = .009) of wild type isocitrate dehydrogenase and mutant isocitrate dehydrogenase patients, respectively; however, the volume of recurrent gross tumor volume outside the gross tumor volume was not significantly different (12.4 ± 16.1 cm 3 vs 8.4 ± 14.2 cm 3 , P = .443). The recurrent gross tumor volume centroid was within 5.7 mm of the closest gross tumor volume edge for 21 (95%) and 22 (100%) of wild type isocitrate dehydrogenase and mutant isocitrate dehydrogenase patients, respectively. Conclusion: The recurrent gross tumor volume extended beyond the gross tumor volume less often in mutant isocitrate dehydrogenase patients possibly implying a differential response to chemoradiotherapy and suggesting isocitrate dehydrogenase status might be used to personalize radiotherapy. The results require validation in prospective randomized trials.
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