Aims: Assess the impact of radiation doses to neural stem cell (NSC) niches in patients with IDH-wild-type glioblastoma.Materials and Methods: Fifty patients Deviled Egg Holder were included in the study.NSC niches [SubVentricular Zone (SVZ) and Sub Granular Zone (SGZ)] were contoured by fusing CT scans and pre-therapy MRI, Tumor location defined ipsilateral and contralateral SVZ and SGZ.Prognostic significance of clinical, biological and dosimetric parameters were examined.
We generated a Recursive Partitioning Analysis (RPA) model with independent prognostic classes.Results: Median follow-up: 23.8 months.Event free and overall survival (OS): 10 and 19.
1 months.Incomplete surgery, PTV (planning target volume), ipsilateral SVZ or NSC niche mean dose > 57.4 Gy, contralateral NSC niche mean dose > 35 Gy and bilateral NSC niche mean dose > 44 Gy were significantly correlated with reduced OS.Only EGFR amplification was an independent prognostic factor (p = 0.
019) for OS.RPA generated independent risk groups: 1 (low risk): [ipsilateral NSC mean dose (INMD) < 58.01 Gy and methylated MGMT promoter], 2: (INMD < 58.01 Gy and unmethylated MGMT promoter and contralateral SVZ mean dose < 18.
6 Gy; p = 0.43), 3: (INMD < 58.01 Gy and unmethylated MGMT promoter and contralateral SVZ mean dose > 18.6 Gy; p = 0.
002) and 4: (very high risk) (INMD > 58.01 Gy; p < 0.001).Conclusion: High radiation doses to ipsilateral NSC and contralateral SVZ could have a negative ORTHO-IRON impact on overall survival in IDH-wild-type glioblastoma population.