Patterns of failure following treatment for glioblastoma multiforme and anaplastic astrocytoma

Wallner, Kent E.; Galicich, Joseph H.; Krol, George; Arbit, Ehud; Malkin, Mark G.

doi:10.1016/0360-3016(89)90941-3

Cited by 723 publications

(342 citation statements)

References 3 publications

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“…These findings are consistent with prior studies that have shown that the vast majority of recurrences occur within 2 cm of the original tumor site [10,30,31] or "in field" (more than 80% of the tumor recurrence residing within the prescription isodose) [32]. The results summarized in Table 3 show that the increased CE, as a presumed sign of tumor recurrence, occurred both within and beyond the prescribed dose of 60 Gy.…”

Section: Discussionsupporting

confidence: 90%

“…Computerized tomography (CT) and magnetic resonance imaging (MRI) are currently used to delineate the target volume for high grade gliomas with MRI providing superior soft tissue contrast [5][6][7]. Target volumes for 3D conformal radiation therapy (3D-CRT) are defined to cover the Gadolinium contrast enhancing region on T1-weighted images obtained from MRI with a uniform margin of 1 to 4 cm [1,[8][9][10] and/or the area of hyperintense lesion on T2-weighted MRI enlarged by several centimeters [11,12].…”

Section: Introductionmentioning

confidence: 99%

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Patterns of Recurrence Analysis in Newly Diagnosed Glioblastoma Multiforme After Three-Dimensional Conformal Radiation Therapy With Respect to Pre–Radiation Therapy Magnetic Resonance Spectroscopic Findings

Park

Tamai

Lee

et al. 2007

International Journal of Radiation Oncology*Biology*Physics

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Purpose-To determine whether the combined MRI and MR spectroscopy imaging (MRSI) prior to radiation therapy (RT) is valuable for RT target definition, and to evaluate the feasibility of replacing the current definition of uniform margins by custom shaped margins based on the information from MRI and MRSI.Methods and Materials-Twenty three GBM patients underwent MRI and MRSI within 4 weeks after surgery but before the initiation of RT and at two month follow-up (FU) intervals thereafter. MRSI data were quantified on the basis of a Choline-to-NAA Index (CNI) as a measure of spectroscopic abnormality. A combined anatomic and metabolic ROI (MRI/S) consisting of T2-weighted hyperintensity, contrast enhancement (CE), resection cavity and CNI2 based on the pre-RT imaging was compared to CNI2 extent and RT dose distribution. The spatial relationship of the pre-RT MRI/S and the RT dose volume was compared to the extent of CE at each FU.Results-Nine patients showed new or increased CE during FU, and 14 patients were either stable or had decreased CE. New or increased areas of CE occurred within CNI2 that was covered by 60 Gy in six patients and within the CNI2 that was not entirely covered by 60 Gy in three patients. New or increased CE resided within the pre-RT MRI/S lesion in 89 % (8/9) of the patients with new or increased CE.Conclusion-These data indicate that the definition of RT target volumes according to the combined morphologic and metabolic abnormality may be sufficient for RT targeting.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Patterns of Recurrence Analysis in Newly Diagnosed Glioblastoma Multiforme After Three-Dimensional Conformal Radiation Therapy With Respect to Pre–Radiation Therapy Magnetic Resonance Spectroscopic Findings

Park

Tamai

Lee

et al. 2007

International Journal of Radiation Oncology*Biology*Physics

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“…The predominant site of tumor recurrence following both surgery and radiation is local. 2 As most tumor recurrences are within the initial tumor bed, direct injection of attenuated oncolytic viruses such as herpes simplex virus-1 (HSV-1) has been proposed as an adjuvant treatment and utilized in Phase I clinical trials for high-grade gliomas. [3][4][5][6][7] HSV-1 is a double-stranded DNA virus expressing its genes in a sequential cascade of immediate-early (a), early (b), and late (g) genes.…”

Section: Introductionmentioning

confidence: 99%

Increased oncolytic efficacy for high-grade gliomas by optimal integration of ionizing radiation into the replicative cycle of HSV-1

et al. 2011

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Oncolytic viruses have been combined with standard cancer therapies to increase therapeutic efficacy. Given the sequential activation of herpes viral genes (herpes simplex virus-1, HSV-1) and the temporal cellular changes induced by ionizing radiation, we hypothesized an optimal temporal sequence existed in combining oncolytic HSV-1 with ionizing radiation. Murine U-87 glioma xenografts were injected with luciferase encoding HSV-1, and ionizing radiation (IR) was given at times before or after viral injection. HSV-1 replication and tumor-volume response were followed. Radiation given 6-9 h after HSV-1 injection resulted in maximal viral luciferase expression and infectious viral production in tumor xenografts. The greatest xenograft regression was also seen with radiation given 6 h after viral injection. We then tested if HSV-1 replication had a dose response to ionizing radiation. HSV-1 luciferase expression exhibited a dose response as xenografts were irradiated from 0 to 5 Gy. There was no difference in viral luciferase expression as IR dose increased from 5 Gy up to 20 Gy. These results suggest that the interaction of IR with the HSV-1 lytic cycle can be manipulated for therapeutic gain by delivering IR at a specific time within viral replicative cycle.

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“…More than 90% of tumors recur within the initial tumor site. 1,2 Among novel approaches to treatment of malignant gliomas are genetically engineered viruses which themselves are cytocidal or capable of delivering genes whose products render the cells susceptible to cytotoxic agents. Assessment of the capacity of herpes simplex viruses (HSV) for treatment of malignant gliomas has taken two approaches.…”

Section: Introductionmentioning

confidence: 99%

Enhancement of replication of genetically engineered herpes simplex viruses by ionizing radiation: a new paradigm for destruction of therapeutically intractable tumors

et al. 1998

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Patterns of failure following treatment for glioblastoma multiforme and anaplastic astrocytoma

Cited by 723 publications

References 3 publications

Patterns of Recurrence Analysis in Newly Diagnosed Glioblastoma Multiforme After Three-Dimensional Conformal Radiation Therapy With Respect to Pre–Radiation Therapy Magnetic Resonance Spectroscopic Findings

Patterns of Recurrence Analysis in Newly Diagnosed Glioblastoma Multiforme After Three-Dimensional Conformal Radiation Therapy With Respect to Pre–Radiation Therapy Magnetic Resonance Spectroscopic Findings

Increased oncolytic efficacy for high-grade gliomas by optimal integration of ionizing radiation into the replicative cycle of HSV-1

Enhancement of replication of genetically engineered herpes simplex viruses by ionizing radiation: a new paradigm for destruction of therapeutically intractable tumors

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