The addition of temozolomide does not change the pattern of progression of glioblastoma multiforme post‐radiotherapy

Abstract

The pattern of progression in our GBM patients does not appear to have been altered by the addition of temozolomide. The overwhelming majority of first PD occurred within the original radiotherapy planning target volume, as is the case in patients treated with radiotherapy alone. Major changes to radiotherapy volumes are not indicated, with alternative strategies required to improve outcomes.

A Survival Analysis with Identification of Prognostic Factors in a Series of 110 Patients with Newly Diagnosed Glioblastoma Before and After Introduction of the Stupp Regimen: A Single-Center Observational Study

“…The results of the present study confirm these data, revealing that better results in terms of overall survival were achieved in patients treated with Stupp protocol, as compared to those, who have radiotherapy with BCNU/CCNU (19 vs 13 months) (p= 0.016) (see Figure 1). On the contrary, some authors [17] observed that the addition of TMZ does not change the pattern of progression of GBM after radiotherapy.…”

Temozolomide and Radiotherapy versus Radiotherapy Alone in High Grade Gliomas: A Very Long Term Comparative Study and Literature Review

“…There is today a large interest in new treatments in gliomas like improvement in surgical techniques such as fluorescence guided resection and neuroendoscopic approaches. New discoveries are made in basic and translation research, and old and new drugs have been proposed as promising agents in brain tumors care [ 41 – 50 ]. More advanced and precise radiation techniques, inhibitors of EGFR, TKI, NF-KB, inhibitors of mTOR, Pi 3k/AKT, proteasome, and new delivery of drugs in nanoparticles, liposomes, and the introduction in clinical practice of antipsychotic drugs (like haloperidol of II and III generation) could be beneficial.…”

Development of an integrated Monte Carlo model for glioblastoma multiforme treated with boron neutron capture therapy

“…This enclosed a dose scoring volume of 9 cm × 9 cm × 0.9 cm (the volume in checked print in Fig. 8 ). This volume was divided into 20 × 20 × 20 μm 3 and each cell within this volume was assigned its corresponding 10 B concentration in addition to the brain material.…”

“…These production thresholds were assigned only to the brain volume (Fig. 8 ). Default thresholds (0.7 mm) were used for the rest of geometry.…”

“…In addition, histopathological studies on the extent of GBM cell infiltration into normal tissue, beyond the Gross Tumour Volume (GTV), show large discrepancies 5 . Marginal and distant GBM recurrences reported in literature 6 , 7 ,could be attributed to the Microscopic Extension (ME) uncertainty, while the high rate of local relapse 8 – 10 , could be explained by intrinsic radioresistance of GBM stem cells and their other aggressive features.…”