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Radiation Oncology
Published in: Radiation Oncology 1/2012

Open Access 01-12-2012 | Research

Patterns of failure after multimodal treatments for high-grade glioma: effectiveness of MIB-1 labeling index

Authors: Kazuyuki Uehara, Takashi Sasayama, Daisuke Miyawaki, Hideki Nishimura, Kenji Yoshida, Yoshiaki Okamoto, Naritoshi Mukumoto, Hiroaki Akasaka, Masamitsu Nishihara, Osamu Fujii, Toshinori Soejima, Kazuro Sugimura, Eiji Kohmura, Ryohei Sasaki

Published in: Radiation Oncology | Issue 1/2012

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Abstract

Background

The purpose of the present study was to analyze the recurrence pattern of high-grade glioma treated with a multimodal treatment approach and to evaluate whether the MIB-1 labeling index (LI) could be a useful marker for predicting the pattern of failure in glioblastoma (GB).

Methods and materials

We evaluated histologically confirmed 131 patients with either anaplastic astrocytoma (AA) or GB. A median dose was 60 Gy. Concomitant and adjuvant chemotherapy were administered to 111 patients. MIB-1 LI was assessed by immunohistochemistry. Recurrence patterns were categorized according to the areas of recurrence as follows: central failure (recurrence in the 95% of 60 Gy); in-field (recurrence in the high-dose volume of 50 Gy; marginal (recurrence outside the high-dose volume) and distant (recurrence outside the RT field).

Results

The median follow-up durations were 13 months for all patients and 19 months for those remaining alive. Among AA patients, the 2-year progression-free and overall survival rates were 23.1% and 39.2%, respectively, while in GB patients, the rates were 13.3% and 27.6%, respectively. The median survival time was 20 months for AA patients and 15 months for GB patients. Among AA patients, recurrences were central in 68.7% of patients; in-field, 18.8%; and distant, 12.5%, while among GB patients, 69.0% of recurrences were central, 15.5% were in-field, 12.1% were marginal, and 3.4% were distant. The MIB-1 LI medians were 18.2% in AA and 29.8% in GB. Interestingly, in patients with GB, the MIB-1 LI had a strong effect on the pattern of failure (P = 0.014), while the extent of surgical removal (P = 0.47) and regimens of chemotherapy (P = 0.57) did not.

Conclusions

MIB-1 LI predominantly affected the pattern of failure in GB patients treated with a multimodal approach, and it might be a useful tool for the management of the disease.
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Metadata
Title
Patterns of failure after multimodal treatments for high-grade glioma: effectiveness of MIB-1 labeling index
Authors
Kazuyuki Uehara
Takashi Sasayama
Daisuke Miyawaki
Hideki Nishimura
Kenji Yoshida
Yoshiaki Okamoto
Naritoshi Mukumoto
Hiroaki Akasaka
Masamitsu Nishihara
Osamu Fujii
Toshinori Soejima
Kazuro Sugimura
Eiji Kohmura
Ryohei Sasaki
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2012
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/1748-717X-7-104

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