Stem cell niche irradiation in glioblastoma: providing a ray of hope?

Glioblastomas are organized hierarchically with a small number of glioblastoma stem cells that have unique self-renewal capacity and multilineage potency. The subventricular zone (SVZ) constitutes the largest neural stem cell niche in the adult human brain; it may also act as a reservoir of glioblastoma stem cells that can initiate, promote or repopulate a tumor. Incidental irradiation of SVZ has been shown to potentially influence outcomes suggesting that aggressively targeting the stem cell niche may offer a ray of hope in glioblastoma. The following review provides a summary of the experimental evidence supporting the origin and location of the putative glioblastoma stem cell in the SVZ, and offers a critical appraisal of the growing body of clinical evidence correlating SVZ dosimetry with outcomes in glioblastoma.