Artikel
Regional blood volume and blood flow as predictive parameters in low grade astrocytomas
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Veröffentlicht: | 20. Mai 2009 |
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Gliederung
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Objective: To establish predictive parameters in low-grade gliomas treated with interstitial radiosurgery we studied astrocytomas WHO II as to their regional blood volume and blood flow and correlated these findings with progression-free and overall survival.
Methods: 38 astrocytomas WHO II were enrolled and rCBF was measured using stable Xenon CT as well as perfusion CT with bolus tracking. rCBV was measured using a two-compartment model and voxel-based analysis for plasma vascular space and extracellular space. Patients were treated with I-125 interstitial radiosurgery and followed for a median of 6.8 years. Correlation between physiological parameters and PFS, OS and a modified McDonald response were performed using multivariate analysis.
Results: rCBV ranged between 0.008 and 0.07 ml/g and was not related to tumor size or location.rCBF ranged from 19.4 to 56.3 ml/100g/min and also was not correlated to size and location. Treatment response and OS were related to rCBV (p<0.05) and inversely related to rCBF (p<0.01). In contrast to previously published work on oligodendrogliomas and response to chemotherapy higher rCBV was associated with a more prolonged response to interstitial radiosurgery.
Conclusions: The rCBV of low grade astrocytomas is an independent prognostic variable for treatment response and substantiates the radiobiological evidence that radiosurgery relies on tumor vessels to be effective.