title: Recurrence patterns of glioblastoma treated with postoperative radiation therapy: relationship between extent of resection and progression-free interval.
abstract: OBJECTIVE
  To evaluate progression pattern and progression-free interval for patients with glioblastoma multiforme (GBM), on the basis of the extent of resection.
  
  
  METHODS
  Between January 2000 and September 2009, 138 patients with GBM underwent postoperative radiation therapy and longitudinal magnetic resonance imaging studies. The operations were classified as biopsy, partial resection (PR), and gross total resection (GTR). Progression patterns were classified as gross tumor volume (GTV), T2 hyperintensity (T2h), distant, and free. We used the Kruskal-Wallis test to compare progression-free intervals on the basis of the extent of resection and the progression pattern.
  
  
  RESULTS
  Recurrence of biopsied and PR tumors at the GTV site was 100 and 97%, respectively. The median progression-free interval was 3 months for biopsied (n = 29), 4 months for PR (n = 70), and 8 months for GTR (n = 39) tumors (p < 0.05). The median progression-free interval for progression patterns classified as GTV (n = 97), T2h (n = 24), distant (n = 12), and free (n = 5) was 3 (p < 0.05), 7, 8, and 29 months, respectively.
  
  
  CONCLUSIONS
  Control of the GTV can increase the progression-free interval because gross residual tumors progress earlier than infiltrating tumor cells do.
authors.affiliation: Department of Medical Imaging, Faculty of Life Sciences, Kumamoto University, 4-24-1 Kuhonji, Kumamoto 862-0976, Japan. murakami@kumamoto-u.ac.jp
authors.forename: Ryuji
authors.initials: R
authors.lastname: Murakami
authors.forename: Toshinori
authors.initials: T
authors.lastname: Hirai
authors.forename: Hideo
authors.initials: H
authors.lastname: Nakamura
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Furusawa
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nakaguchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Uetani
authors.forename: Mika
authors.initials: M
authors.lastname: Kitajima
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Yamashita
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001932:Brain Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D002648:Child; D003287:Contrast Media; D018450:Disease Progression; D005260:Female; D019786:Gadolinium DTPA; D005909:Glioblastoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000628:therapy; D018709:Statistics, Nonparametric; D047368:Tumor Burden
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA