{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T19:49:45Z","timestamp":1785527385905,"version":"3.56.0"},"reference-count":14,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background: Current target volume delineation protocols for glioblastoma utilise uniform or isotropic expansion around the surgical cavity and residual tumour, without considering specific sites at risk for infiltration. Tumours arising in different neuroanatomical sites may demonstrate distinct patterns of infiltration. This study aims to review the infiltration and progression sites for the occipital lobe glioblastoma to identify sites potentially at risk. Methods: Patients with occipital lobe glioblastoma managed according to the EORTC-NCIC protocol were identified through a prospective database. Based on MRI analysis, a qualitative description of sites of tumour infiltration and subsequent progression was performed. These were categorised into neuroanatomical subsites adjacent to the occipital lobe: level 1 related to the origin gyrus; level 2 related to adjacent gyral subsites; and level 3 related to subsites that involved distant regions. Patients could be classified in more than one level where multifocal involvement was present at diagnosis or progression. Spatial patterns were assessed in relation to three major white matter tracts: inferior longitudinal fasciculus, cingulum, and corpus callosum. Results: A total of 46 patients were analysed. At diagnosis, 20 patients (43.5%) had medial occipital lobe involvement and 26 (56.5%) had lateral involvement. Level 2 and level 3 infiltration were observed in 33 (71.7%) and 27 (58.7%) patients. Progression occurred in 43 patients (93.5%), with involvement at level 1 in 28%, level 2 in 77%, and level 3 in 98%. Lateral tumours demonstrated proportionately higher progression in the trigone (75% vs. 52.6%) and anterior temporal lobe (50% vs. 15.8%, p = 0.026), while medial tumours more frequently involved the splenium (47.3% vs. 16.7%, p = 0.046). Conclusions: Infiltration and progression of occipital lobe glioblastoma may demonstrate distinct neuroanatomical patterns, with spatial distribution corresponding to major white matter tracts.<\/jats:p>","DOI":"10.3390\/brainsci16030329","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T11:50:36Z","timestamp":1773921036000},"page":"329","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessment of Patterns of Infiltration and Relapse of Patients with Glioblastoma of the Occipital Lobe"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9735-1322","authenticated-orcid":false,"given":"Michal","family":"Schulenkowski","sequence":"first","affiliation":[{"name":"Central Coast Cancer Centre, Gosford 2250, Australia"},{"name":"Melbourne Medical School, The University of Melbourne, Melbourne 3053, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4015-9724","authenticated-orcid":false,"given":"Chun Khai","family":"Loh","sequence":"additional","affiliation":[{"name":"Central Coast Cancer Centre, Gosford 2250, Australia"},{"name":"Sydney Medical School, The University of Sydney, Sydney 2000, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2363-8333","authenticated-orcid":false,"given":"Michael","family":"Back","sequence":"additional","affiliation":[{"name":"Central Coast Cancer Centre, Gosford 2250, Australia"},{"name":"Sydney Medical School, The University of Sydney, Sydney 2000, Australia"},{"name":"Northern Sydney Cancer Centre, Sydney 2060, Australia"},{"name":"The Brain Cancer Group, Sydney 2065, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1016\/S1474-4422(24)00160-1","article-title":"Glioblastoma and brain connectivity: The need for a paradigm shift","volume":"23","author":"Salvalaggio","year":"2024","journal-title":"Lancet Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1016\/S0140-6736(23)01054-1","article-title":"Primary brain tumours in adults","volume":"402","author":"Bent","year":"2023","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/S1470-2045(09)70025-7","article-title":"Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial","volume":"10","author":"Stupp","year":"2009","journal-title":"Lancet Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1007\/s12325-011-0007-3","article-title":"AVAglio: Phase 3 trial of bevacizumab plus temozolomide and radiotherapy in newly diagnosed glioblastoma multiforme","volume":"28","author":"Chinot","year":"2011","journal-title":"Adv. Ther."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1056\/NEJMoa1308573","article-title":"A Randomized Trial of Bevacizumab for Newly Diagnosed Glioblastoma","volume":"370","author":"Gilbert","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1093\/neuonc\/not106","article-title":"Angiogenesis inhibition for glioblastoma at the edge: Beyond AVAGlio and RTOG 0825","volume":"15","author":"Weller","year":"2013","journal-title":"Neuro-Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1016\/S1470-2045(14)70379-1","article-title":"Cilengitide combined with standard treatment for patients with newly diagnosed glioblastoma with methylated MGMT promoter (CENTRIC EORTC 26071-22072 study): A multicentre, randomised, open-label, phase 3 trial","volume":"15","author":"Stupp","year":"2014","journal-title":"Lancet Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"109663","DOI":"10.1016\/j.radonc.2023.109663","article-title":"ESTRO-EANO guideline on target delineation and radiotherapy details for glioblastoma","volume":"184","author":"Niyazi","year":"2023","journal-title":"Radiother. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1056\/NEJMoa043330","article-title":"Radiotherapy plus Concomitant and Adjuvant Temozolomide for Glioblastoma","volume":"352","author":"Stupp","year":"2005","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1212\/WNL.30.9.907","article-title":"Assumptions in the radiotherapy of glioblastoma","volume":"30","author":"Hochberg","year":"1980","journal-title":"Neurology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"698","DOI":"10.3171\/jns.1988.68.5.0698","article-title":"Topographic anatomy and CT correlations in the untreated glioblastoma multiforme","volume":"68","author":"Burger","year":"1988","journal-title":"J. Neurosurg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1186\/1748-717X-9-130","article-title":"Patterns of failure for glioblastoma multiforme following limited-margin radiation and concurrent temozolomide","volume":"9","author":"Gebhardt","year":"2014","journal-title":"Radiat. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"20211232","DOI":"10.1259\/bjr.20211232","article-title":"Challenges and opportunities for advanced neuroimaging of glioblastoma","volume":"96","author":"Henssen","year":"2022","journal-title":"Br. J. Radiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1215\/15228517-2007-016","article-title":"Incidence of gliomas by anatomic location","volume":"9","author":"Larjavaara","year":"2007","journal-title":"Neuro-Oncol."}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/16\/3\/329\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T12:13:54Z","timestamp":1773922434000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/16\/3\/329"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,19]]},"references-count":14,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["brainsci16030329"],"URL":"https:\/\/doi.org\/10.3390\/brainsci16030329","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,19]]}}}