Quality assurance of an image guided intracranial stereotactic positioning system for radiosurgery treatment with helical tomotherapy |
| |
Authors: | Emilie T Soisson Nick Hardcastle " target="_blank">Wolfgang A Tomé |
| |
Institution: | 1.Department of Oncology,Cross Cancer Institute & University of Alberta,Edmonton,Canada;2.Department of Oncology,Institut Gustave Roussy,Villejuif,France;3.Department of Statistic and Clinical Research,Schering-Plough,Levallois-Perret Cedex,France;4.Department of Pathology,H?pital Kremlin Bicetre and Universite Paris XI,Le Kremlin-Bicetre,France |
| |
Abstract: | According to World Health Organization (WHO) and Daumas-Duport grading systems, progression of oligodendrogliomas (ODGs) to
a higher grade (WHO grade III, grade B) is associated with increased angiogenesis. Based on multivariate assessment of molecular,
pathological, and radiological parameters, we further assessed the influence of tumor angiogenesis on tumor progression and
patient survival. Patients with a diagnosis of ODG, consecutively treated in a single institution, were reviewed and reclassified
according to WHO and Daumas-Duport grading systems. MRI scans were reviewed to assess contrast enhancement and necrosis. Tissue
sections were used for pathology review and to evaluate immunostaining of vascular endothelial growth factor (VEGF), vascular
endothelial growth factor receptor (VEGF-R), Ki-67, and CD34. Multivariate analysis was performed to assess the impact of
tumor angiogenesis-related pathological and radiological factors on patient survival. One hundred thirty-four patients with
pure ODG were included in this study. Multivariate analysis identified four independent poor prognostic factors: necrosis,
absence of seizure, increased vascularization, and age >55 years. A subgroup of patients with tumor necrosis, increased vascularization,
and absence of seizures had a significantly worse outcome than predicted, with a median overall survival of 14.2 months. VEGF
expression was significantly higher in this subgroup and correlated with disease progression regardless of histologic grade.
Based on the presence of radiological or pathological necrosis, contrast enhancement or endothelial hyperplasia, and absence
of seizures, a high risk group of ODG can be identified with significantly worse overall survival. Also, VEGF over-expression
in ODG constitutes an early marker for predicting tumor progression. |
| |
Keywords: | |
本文献已被 SpringerLink 等数据库收录! |
|