Temozolomide during and after radiation therapy for WHO grade III gliomas: preliminary report of a prospective multicenter study

2010 ◽  
Vol 103 (3) ◽  
pp. 503-512 ◽  
Author(s):  
Young-Hoon Kim ◽  
Chul-Kee Park ◽  
Won Ho Cho ◽  
In Ah Kim ◽  
Seyoung Moon ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Multicenter Study ◽  
Preliminary Report ◽  
Prospective Multicenter Study ◽  
Who Grade ◽  
Who Grade Iii ◽  
Grade Iii

scholarly journals EPID-09. PROGNOSTIC FACTORS IN ADULT PATIENTS WITH PRIMARY INTRACRANIAL EPENDYMOMAS: A POPULATION-BASED STUDY

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi76-vi76
Author(s):  
Helen Yang ◽  
Abdullah Malik ◽  
Sunit Das
Keyword(s):  
Radiation Therapy ◽  
Prognostic Factors ◽  
Health Care Professionals ◽  
Adult Patients ◽  
Age At Diagnosis ◽  
Who Grade ◽  
Intracranial Ependymoma ◽  
One Year ◽  
Who Grade Iii ◽  
Grade Iii

Abstract BACKGROUND Outcomes for patients with intracranial ependymoma remain poor in the current era of cancer treatment. This study aims to investigate the prognostic value of demographic and clinical variables to predict survival using the largest current database of patients with intracranial ependymoma. METHODS The Surveillance, Epidemiology and End Results (SEER) registry was queried for prognostic factors and survival outcomes of adult (≥18 years) patients diagnosed with intracranial ependymoma from 2004–2016. Survival was estimated using Kaplan Meier curves. Cox proportional hazards modeling was used to identify correlates of survival. RESULTS We identified a cohort of 229 primary intracranial ependymoma patients. The cohort showed a slight male predominance (52%) and had a mean age of 43 ± 17 years. 107 patients (47%) had WHO grade II tumors and 122 patients (53%) had WHO grade III tumors. One year survival was 85% for the entire cohort. Increasing age at diagnosis (HR: 1.05, 95% CI: 1.03–1.07) and WHO grade III tumor (HR: 4.20, 95% CI: 2.02–8.75) were independently associated with mortality after adjusting for age, sex, tumor location, extent of surgery, use of radiation therapy, and use of chemotherapy. Use of radiation therapy was associated with better one-year survival in cases of gross total resection (GTR) and subtotal resection (STR). Use of chemotherapy was not associated with mortality in the adjusted analysis (HR: 2.16, 95% CI: 0.96–4.84). CONCLUSION Our results suggest that age at diagnosis and tumor grade are independent factors associated with mortality in adult patients with intracranial ependymoma. Furthermore, use of chemotherapy was not shown to decrease mortality. These findings help guide future prognostic model making and therapeutic strategies designed by health care professionals.

Acute toxicity analysis of patients receiving surgery, Gliadel wafer implantation, and postoperative daily temozolomide with radiation therapy for primary high-grade glioma

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 11504-11504 ◽  
Author(s):  
C. R. Heery ◽  
A. Desjardins ◽  
J. A. Quinn ◽  
J. N. Rich ◽  
S. Gururangan ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Acute Toxicity ◽  
High Grade Glioma ◽  
Wound Complications ◽  
Hematologic Toxicity ◽  
Who Grade ◽  
Initial Surgery ◽  
Grade 3 ◽  
Who Grade Iii ◽  
Grade Iii

11504 Background: Treatment of patients with newly diagnosed malignant glioma using Gliadel wafer implantation at initial surgery has been shown to increase survival (Westphal et al 2003). Similarly, administration of temozolomide during and after radiotherapy has also been shown to increase survival in this patient population (Stupp et al 2005). Accordingly use of both Gliadel and temozolomide may be advantageous for these patients although it is possible that the toxicity of these two approaches used together might be prohibitive. Methods: The Preston Robert Tisch Brain Tumor Center at Duke has occasionally treated with this approach over the last several years, and we now present an analysis of the observed acute toxicity. We retrospectively reviewed the Duke patients treated with surgery plus Gliadel wafer placement followed by daily temozolomide (75 mg/m2-150 mg/m2) and radiation therapy. Results: Of 28 patients reviewed, four patients were diagnosed with AA (WHO grade III), two patients were diagnosed with AO (WHO grade III) and the remaining 22 patients were diagnosed with glioblastoma multiforme (WHO grade IV). Two of the 28 7.1%) patients experienced grade 3 or 4 hematologic toxicity during radiation and daily temozolomide therapy. This is similar to the 7% of patients found to have hematologic toxicity reported by Stupp et al (2005). Three patients (10.7%) had grade 3 or 4 seizure activity. Two patients (7.1%) had grade 4 pulmonary emboli. No events of cerebral edema or wound complications were noted in this review of patient events following Gliadel wafer placement. Conclusions: In summary, the addition of Gliadel wafer placement at the time of surgery followed by radiation therapy with concurrent daily low dose temozolomide does not appear to have significant acute toxicity over that observed with radiation therapy and daily temozolomide. Future formal trials combining these therapeutic strategies may allow evaluation of the possible survival advantage associated with this approach. [Table: see text]

Radiotherapy with Concomitant Temozolomide in WHO Grade III Glial Tumors

2008 ◽  
Vol 72 (1) ◽  
pp. S235
Author(s):  
F. Zorlu ◽  
M. Gurkaynak ◽  
U. Selek ◽  
S. Ulger ◽  
A. Turker ◽  
...  
Keyword(s):  
Who Grade ◽  
Glial Tumors ◽  
Who Grade Iii ◽  
Grade Iii

scholarly journals High-grade glioma with anterior skull base erosion and intranasal extension: case report

2017 ◽  
Vol 126 (5) ◽  
pp. 1484-1487 ◽  
Author(s):  
Matthew T. Stib ◽  
Michael Johnson ◽  
Alan Siu ◽  
M. Isabel Almira-Suarez ◽  
Zachary Litvack ◽  
...  
Keyword(s):  
Nasal Cavity ◽  
Skull Base ◽  
Radiation Treatment ◽  
High Grade Glioma ◽  
Brain Parenchyma ◽  
Anterior Skull Base ◽  
High Grade ◽  
Who Grade ◽  
Who Grade Iii ◽  
Grade Iii

The authors describe the case of a large WHO Grade III anaplastic oligoastrocytoma extending through the anterior skull base and into the right nasal cavity and sinuses. Glial neoplasms are typically confined to the intracranial compartment within the brain parenchyma and rarely extend into the nasal cavity without prior surgical or radiation therapy. This 42-year-old woman presented with progressive headaches and sinus congestion. MR imaging findings revealed a large intracranial lesion with intranasal extension. Endoscopic nasal biopsy revealed pathology consistent with an infiltrating glioma. The patient subsequently underwent a combined transcranial/endonasal endoscopic approach for resection of this lesion. Pathological diagnosis revealed a WHO Grade III oligoastrocytoma. This report reviews the mechanisms of extradural glioma extension. To the authors' knowledge, it is the second report of a high-grade glioma exhibiting nasal extension without prior surgical or radiation treatment.

scholarly journals The Expression of Progesterone Receptors in Meningiomas of Different Grades

2019 ◽  
Vol 8 (2) ◽  
pp. 65-69
Author(s):  
Mohammad Tahir ◽  
Tehreem Atif ◽  
Summaya Sohail ◽  
Arfa Nawazish ◽  
Huma Mushtaq
Keyword(s):  
Progesterone Receptor ◽  
Treatment Options ◽  
Progesterone Receptors ◽  
Lower Grade ◽  
Immunoperoxidase Method ◽  
Nuclear Staining ◽  
Who Grade ◽  
Grade Ii ◽  
Who Grade Iii ◽  
Grade Iii

Background: Meningiomas are slow growing intracranial and intraspinal neoplasms with a tendency to recur locally. WHO grades them as I (benign), II (atypical) and III (anaplastic) in order of their increasing aggressiveness, based on histological parameters and brain parenchymal invasion. Progesterone receptors (PR) are more prevalent amongst the lower grade meningiomas. The objective of this study was to determine the immunohistochemical expression of progesterone receptors in meningiomas of different grades.Material and Methods: A total of 100 cases were selected over a period of 2.5 years. Three to five microns’ thick sections stained with Hematoxylin and Eosin were examined microscopically by a team of two Histopathologists and graded into grades I, II and III, according to 2016 WHO classification criteria. Another section of the original tumor was stained with progesterone receptor antibody using the conventional immunoperoxidase method. Stained slides were than examined by the same team of Histopathologists and declared positive (if nuclear staining was observed in more than 10% of tumor cells) or negative. Statistical analysis was done using SPSS version 21.Results: Out of a total of 100 cases of meningioma, there were 79 cases of benign/typical WHO grade I, 15 cases of atypical/ WHO grade II and 6 cases of anaplastic/ WHO grade III tumor. PR status was positive in 89.8 % (71/79) of grade I meningiomas and 46.6 % (7/15) of grade II/Atypical meningiomas. The 06 cases of Anaplastic/WHO grade III tumors were negative for PR. There was a higher prevalence of Progesterone receptors in female patients (89.8%; 53/59) as compared to male meningioma patients (60.9%; 25/41).Conclusion: We observed a decreased expression of progesterone receptor in higher grades of meningioma in this study. It is an effort to explore conservative treatment options for inoperable lesions, as anti-progesterone therapy may hold a promise as a new treatment option in the near future.

High-grade gliomas and molecular biology of neurosurgical oncology

2019 ◽  
pp. 89-106
Author(s):  
Stephen J Price ◽  
Harry Bulstrode ◽  
Richard Mair
Keyword(s):  
Molecular Markers ◽  
Who Classification ◽  
High Grade Glioma ◽  
High Grade ◽  
Optimal Management ◽  
Who Grade ◽  
Normal Human ◽  
Who Grade Iii ◽  
Grade Iii

The term high-grade glioma (HGG) encompasses a number of histological entities that are considered by the WHO Classification as WHO Grade III and IV tumours. They have traditionally been considered as having similar behaviour and had been treated in a similar manner but recent advances in our understanding of tumour biology have led to the identification of molecular markers that are now central to the classification of these tumours. Normal human cells develop into cancer cells through a stepwise accumulation of genomic and epigenomic alterations and this chapter considers the molecular markers of gliomas and explains their significance before going on to discuss the optimal management.

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