Dataset Information

High dose vs low dose irradiation of the subventricular zone in patients with glioblastoma-a systematic review and meta-analysis.

ABSTRACT:

Purpose

The published data indicate that the irradiation of the subventricular zone (SVZ) might play a role in the treatment of patients with glioblastoma (GBM). We aimed to determine whether radiation treatment doses (high vs low) applied to the SVZ can lead to an increase in progression free survival (PFS) and overall survival (OS).

Patients and methods

We undertook a systematic review and meta-analysis according to the PICOS research criteria of patients with glioblastoma which received high doses compared to low doses in order to determine if they have a better survival in observational and experimental studies.

Results

Our survey of the literature yielded 2573 unique records. After screening, 17 were assessed for eligibility, and in the end 8 were included in the qualitative and 4 in the quantitative analysis. Subjects who received higher doses of ipsilateral SVZ (iSVZ) irradiation had a statistically significant better PFS than those receiving lower doses (HR 0.58 [95% CI 0.42-0.82], p=0.002). Subjects receiving higher doses of contralateral SVZ (cSVZ) irradiation did not have a statistically significant better PFS than those receiving lower doses (HR =0.89 [95% CI 0.35-2.26], p=0.81). Also for OS the subjects receiving higher doses to the iSVZ did not have a statistically significant better survival than those receiving lower doses (HR =0.75 [95% CI 0.51-1.11], p=0.15).

Conclusion

The data indicate a possible involvement of the SVZ in the onset and progression of the GBM, as well as a possible role of the SVZ in radiation therapy.

SUBMITTER: Susman S

PROVIDER: S-EPMC6645358 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

High dose vs low dose irradiation of the subventricular zone in patients with glioblastoma-a systematic review and meta-analysis.

Şuşman Sergiu S Leucuţa Daniel-Corneliu DC Kacso Gabriel G Florian Ştefan Ioan ŞI

Cancer management and research 20190718

<h4>Purpose</h4>The published data indicate that the irradiation of the subventricular zone (SVZ) might play a role in the treatment of patients with glioblastoma (GBM). We aimed to determine whether radiation treatment doses (high vs low) applied to the SVZ can lead to an increase in progression free survival (PFS) and overall survival (OS).<h4>Patients and methods</h4>We undertook a systematic review and meta-analysis according to the PICOS research criteria of patients with glioblastoma which ...[more]

PMID: 31410064

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Project description:BackgroundGlioblastoma (GBM) is the most aggressive and common type of primary brain tumor in adults. Tumor location plays a role in patient prognosis, with tumors proximal to the lateral ventricles (LVs) presenting with worse overall survival, increased expression of stem cell genes, and increased incidence of distal tumor recurrence. This may be due in part to interaction of GBM with factors of the subventricular zone (SVZ), including those contained within the cerebrospinal fluid (CSF). However, direct interaction of GBM tumors with CSF has not been proved and would be hindered in the presence of an intact ependymal cell layer.MethodsHere, we investigate the ependymal cell barrier and its derived extracellular matrix (ECM) fractones in the vicinity of a GBM tumor. Patient-derived GBM cells were orthotopically implanted into immunosuppressed athymic mice in locations distal and proximal to the LV. A PBS vehicle injection in the proximal location was included as a control. At four weeks post-xenograft, brain tissue was examined for alterations in ependymal cell health via immunohistochemistry, scanning electron microscopy, and transmission electron microscopy.ResultsWe identified local invading GBM cells within the LV wall and increased influx of CSF into the LV-proximal GBM tumor bulk compared to controls. In addition to the physical disruption of the ependymal cell barrier, we also identified increased signs of compromised ependymal cell health in LV-proximal tumor-bearing mice. These signs include increased accumulation of lipid droplets, decreased cilia length and number, and decreased expression of cell channel proteins. We additionally identified elevated numbers of small fractones in the SVZ within this group, suggesting increased indirect CSF-contained molecule signaling to tumor cells.ConclusionsOur data is the first to show that LV-proximal GBMs physically disrupt the ependymal cell barrier in animal models, resulting in disruptions in ependymal cell biology and increased CSF interaction with the tumor bulk. These findings point to ependymal cell health and CSF-contained molecules as potential axes for therapeutic targeting in the treatment of GBM.

Dataset Information

High dose vs low dose irradiation of the subventricular zone in patients with glioblastoma-a systematic review and meta-analysis.

Purpose

Patients and methods

Results

Conclusion

Publications

High dose vs low dose irradiation of the subventricular zone in patients with glioblastoma-a systematic review and meta-analysis.

Similar Datasets

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