Glioblastoma recurrence patterns after radiation therapy with regard to the subventricular zone

Int J Radiat Oncol Biol Phys. 2014 Nov 15;90(4):886-93. doi: 10.1016/j.ijrobp.2014.07.027. Epub 2014 Sep 11.


Purpose: We evaluated the influence of tumor location and tumor spread in primary glioblastoma (GBM), with respect to the subventricular zone (SVZ), on recurrence behavior, progression-free survival (PFS), and overall survival (OS).

Methods and materials: 607 patients (376 male and 231 female) with a median age of 61.3 years (range, 3.0-87.9 years) and primary GBM treated with radiation therapy (RT) from 2004 to 2012 at a single institution were included in this retrospective study. Preoperative images and follow-up examination results were assessed to evaluate tumor location. Tumors were classified according to the tumor location in relation to the SVZ.

Results: The median PFS of the study population was 5.2 months (range, 1-91 months), and the median OS was 13.8 months (range, 1-102 months). Kaplan-Meier analysis showed that tumor location in close proximity to the SVZ was associated with a significant decline in PFS and OS (4.8 and 12.3 months, respectively; each P<.001). Furthermore, in cases where tumors were involved with the SVZ, distant cerebral progression (43.8%; P=.005) and multifocal progression (39.8%; P=.008) were more common. Interestingly, opening of the ventricle during the previous surgery showed no impact on PFS and OS.

Conclusion: GBM in close proximity to the SVZ was associated with decreased survival and had a higher risk of multifocal or distant progression. Ventricle opening during surgery had no effect on survival rates.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Alkylating / therapeutic use
  • Brain Neoplasms / mortality
  • Brain Neoplasms / pathology*
  • Brain Neoplasms / radiotherapy*
  • Brain Neoplasms / therapy
  • Child
  • Child, Preschool
  • Dacarbazine / analogs & derivatives
  • Dacarbazine / therapeutic use
  • Disease-Free Survival
  • Female
  • Glioblastoma / mortality
  • Glioblastoma / pathology*
  • Glioblastoma / radiotherapy*
  • Glioblastoma / therapy
  • Humans
  • Karnofsky Performance Status
  • Lateral Ventricles* / surgery
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / pathology*
  • Retrospective Studies
  • Temozolomide
  • Young Adult


  • Antineoplastic Agents, Alkylating
  • Dacarbazine
  • Temozolomide