Journal of Neurological Sciences (Turkish) 2017 , Vol 34 , Num 4
Retrospective Clinical and Radiologic Analysis of Adult High-Grade Glioma Recurrence After Temozolomide-Based Radiochemotherapy
Burcu AKBELEN1,Serra KAMER1,Cem CALLI2,Sinan HOCA1,Yavuz ANACAK1
1Ege University, Radiation Oncology, İzmir, Turkey
2Ege University, Radiology, İzmir, Turkey
DOI : 10.24165/jns.8856.15 Background: The aim of this study was to evaluate the recurrence patterns and the times of recurrence after temozolomide-based radiochemotherapy for high grade gliomas.

Methods: Magnetic resonance imaging (MRI), diffusion MRI, perfusion MRI, and MRI spectroscopy scans of 30 patients who were treated with radiotherapy concurrently with temozolomide chemotherapy between June 2009 and April 2012 were retrospectively evaluated. Central, in-field, marginal, and distant recurrences of progression were defined related to radiation therapy dose distribution (90% isodose line).

Results: The overall survival (OS) rates of central recurrences at 1 year and 2 years were 78% and 25%, respectively (at a median of 16 months). The OS rate of in-field, marginal and distant recurrences at 1 year and 2 years were 100% and 40%, respectively (at a median of 24 months). The progression-free survival (PFS) rate of central recurrences at 1 year and 2 years were 21% and 0%, respectively (at a median of 5 months). The PFS rate of in-field, marginal and distant recurrences at 1 year and 2 years were 36% and 27%, respectively (at a median of 11 months). The PFS rate of pseudoprogression at 1 year and 2 years were 87% and 43% (range, 7-31 months).

Conclusions: The survival of new in-field, marginal and distant recurrences are longer and these new lesions develop at a later time compared with central recurrences. Pseudoprogression predicts better response to temozolomide-based radiochemotherapy. Finally, the location of recurrence is determined as one of the prognostic factors for OS and PFS. Keywords : Glioblastoma, radiochemoterapy, temozolomide, recurrence, pseudoprogression