Journal of Neurological Sciences (Turkish) Ahead Of Print
RETROSPECTIVE STUDY OF CLINICAL AND RADIOLOGICAL ANALYSIS OF ADULT HIGH GRADE GLIOMA RECURRENCES AFTER TEMOZOLOMIDE BASED RADIOCHEMOTHERAPY
Burcu Akbelen1, Serra Kamer1, Cem Callı2, Sinan Hoca1, Yavuz Anacak1
1Ege University, Radiation Oncology, İzmir,
2Ege University, Radiology, İzmir,
DOI : 10.24165/jns.8856.15 Background: The aim of this study is to evaluate the recurrence patterns and the time 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-April 2012 were retrospectively evaluated. Central, in-field, marginal and distant recurrences of progression were defined related to the radiation therapy dose distribution (90% isodose line). Results: The overall survival (OS) rate of central recurrences at 1 year and 2 years were 78% and 25% respectively (at a median of 16 months). 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). 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). PFS rate of pseudoprogression at 1 year and 2 years were 87% and 43% ( between 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 to the central recurrences. Pseudoprogression predicts better response to temozolomide based radiochemotherapy. Finally, the localization of recurrences are determined as one of the prognostic factors for OS and PFS. Keywords : Glioblastoma, radiochemoterapy, temozolomide, recurrence, pseudoprogression.