Peritumoral brain zone in glioblastoma: biological, clinical and mechanical features

Abstract

Glioblastoma is a highly aggressive and invasive tumor that affects the central nervous system (CNS). With a five-year survival rate of only 6.9% and a median survival time of eight months, it has the lowest survival rate among CNS tumors. Its treatment consists of surgical resection, subsequent fractionated radiotherapy and concomitant and adjuvant chemotherapy with temozolomide. Despite the implementation of clinical interventions, recurrence is a common occurrence, with over 80% of cases arising at the edge of the resection cavity a few months after treatment. The high recurrence rate and location of glioblastoma indicate the need for a better understanding of the peritumor brain zone (PBZ). In this review, we first describe the main radiological, cellular, molecular and biomechanical tissue features of PBZ; and subsequently, we discuss its current clinical management, potential local therapeutic approaches and future prospects.

VC-resist glioblastoma cell state: vessel co-option as a key driver of chemoradiation resistance

“…Among the distinct invasion strategies used by GBM cells, vessel co-option is remarkable because it may be a link between chemoradiation resistance, tumor cell plasticity and infiltration far from the tumor bulk. Vessel co-option is the active movement of tumor cells towards blood vessels and at the invasive front of GBM it gives rise to perivascular satellitosis, one of the GBM hallmarks 20 – 23 . Moreover, the perivascular niche is a reservoir of protective factors that may induce GBM cells survival, resistance to therapy, progression and dissemination 21 , 24 , 25 .…”