Outcome analysis of patients treated for high grade gliomas: long term evaluation of mixed beam therapy

Brain tumors in infants account for less than 10% of all pediatric nervous system tumors. They include tumors diagnosed in fetal age, neonatal age and in the first years of life. Among these, high-grade gliomas (HGGs) are a specific entity with a paradoxical clinical course that sets them apart from their pediatric and adult counterparts. Currently, surgery represents the main therapeutic strategy in the management of these tumors. Chemotherapy does not have a well-defined role whilst radiotherapy is rarely performed, considering its late effects. Information about molecular characterization is still limited, but it could represent a new fundamental tool in the therapeutic perspective of these tumors. Chimeric proteins derived from the fusion of several genes with neurotrophic tyrosine receptor kinase mutations have been described in high-grade gliomas in infants as well as in neonatal age and the recent discovery of targeted drugs may change the long-term prognosis of these tumors, along with other target-driven therapies. The aim of this mini review is to highlight the recent advances in the diagnosis and treatment of high-grade gliomas in infants with a particular focus on the molecular landscape of these neoplasms and future clinical applications.

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Long-term follow-up of neuropsychological functions in patients with high grade gliomas: can cognitive status predict patient’s outcome after surgery?

Acta Neurochirurgica ◽

10.1007/s00701-020-04230-y ◽

2020 ◽

Vol 162 (4) ◽

pp. 803-812 ◽

Cited By ~ 2

Author(s):

Barbara Zarino ◽

Andrea Di Cristofori ◽

Giorgia Abete Fornara ◽

Giulio Andrea Bertani ◽

Marco Locatelli ◽

...

Keyword(s):

Cognitive Status ◽

High Grade ◽

Long Term Follow Up ◽

Neuropsychological Functions ◽

High Grade Gliomas ◽

Patient’S Outcome

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Temozolomide and Radiotherapy versus Radiotherapy Alone in High Grade Gliomas: A Very Long Term Comparative Study and Literature Review

BioMed Research International ◽

10.1155/2015/620643 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 9

Author(s):

Salvatore Parisi ◽

Pietro Corsa ◽

Arcangela Raguso ◽

Antonio Perrone ◽

Sabrina Cossa ◽

...

Keyword(s):

Combined Treatment ◽

Haematological Toxicity ◽

High Grade ◽

Term Survival ◽

Long Time ◽

Radiotherapy Alone ◽

High Grade Gliomas ◽

Time Basis ◽

Grade 3

Temozolomide (TMZ) is the first line drug in the care of high grade gliomas. The combined treatment of TMZ plus radiotherapy is more effective in the care of brain gliomas then radiotherapy alone. Aim of this report is a survival comparison, on a long time (>10 years) span, of glioma patients treated with radiotherapy alone and with radiotherapy + TMZ.Materials and Methods. In this report we retrospectively reviewed the outcome of 128 consecutive pts with diagnosis of high grade gliomas referred to our institutions from April 1994 to November 2001. The first 64 pts were treated with RT alone and the other 64 with a combination of RT and adjuvant or concomitant TMZ.Results. Grade 3 (G3) haematological toxicity was recorded in 6 (9%) of 64 pts treated with RT and TMZ. No G4 haematological toxicity was observed. Age, histology, and administration of TMZ were statistically significant prognostic factors associated with 2 years overall survival (OS). PFS was for GBM 9 months, for AA 11.Conclusions. The combination of RT and TMZ improves long term survival in glioma patients. Our results confirm the superiority of the combination on a long time basis.

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RTOG randomized, dose-searching study of mixed beam (neutron/photon) irradiation for high grade gliomas of the brain

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/0360-3016(86)90518-3 ◽

1986 ◽

Vol 12 ◽

pp. 99

Author(s):

G.E. Laramore ◽

M. Diener-West ◽

T.W. Griffin ◽

M.L. Griem ◽

F.J. Thonas ◽

...

Keyword(s):

High Grade ◽

Photon Irradiation ◽

Mixed Beam ◽

High Grade Gliomas ◽

The Brain

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NCOG-09. PREDICTIVE GERIATRIC FACTORS IN ELDERLY PATIENTS TREATED FOR IDH-MUTANT HIGH-GRADE GLIOMAS: A FRENCH POLA NETWORK STUDY

Neuro-Oncology ◽

10.1093/neuonc/noab196.600 ◽

2021 ◽

Vol 23 (Supplement_6) ◽

pp. vi153-vi153

Author(s):

Coline Montégut ◽

Jean-Sébastien Guillamo ◽

François Ducray ◽

Caroline Dehais ◽

Cohen-Jonathan Moyal Elisabeth ◽

...

Keyword(s):

Body Mass Index ◽

Elderly Patients ◽

Body Mass ◽

The Elderly ◽

High Grade ◽

Neuropsychological Disorders ◽

Comorbidity Index ◽

High Grade Gliomas ◽

And Biological Markers

Abstract We aimed to describe the characteristics, patterns of care and predictive geriatric factors of elderly patients with IDH-mutant (IDHm) high-grade gliomas (HGG) included in the French POLA network, dedicated to HGG (including 68% of IDHm HGG). For IDHm HGG patients over the age of 70 years, geriatric features were collected: G8 score items (appetite, weight loss, mobility, neuropsychological disorders, body mass index, medications, self-rated health, age), Activities and Instrumental Activities of Daily Living (ADL, IADL) scores, Charlson’s comorbidity Index (CCI) and biological markers. Out of the 1433 HGG patients included in the POLA Network, 119 (8.3%) occurred in patients ≥ 70 years. Among them, 39 presented with IDHm HGG. Of these 39 patients, estimated G8 score was ≤ 14/17 for 16 patients (64%), ADL score was < 6 for 33.3%, IADL score was < 4 for 47% and CCI was ≥ 5 for 72%. Regarding treatment feasibility, 6 of the 19 patients treated by temozolomide prematurely discontinued chemotherapy including 2 for toxicity and 4 for progression. Five of the 10 patients treated by PCV prematurely discontinued chemotherapy, all for toxicity. In multivariate analysis, loss of mobility (p=0.018; p=0.008), severe neuropsychological disorders (p=0.005; p=0.047), body mass index < 21 kg/m2 (p=0.002; p=0.006) and ADL score < 6 (p=0.002; p=0.01) were significantly predictive of poor PFS and OS. Then we generated a specific brain geriatric score including these four items with a sensibility, specificity and AUC for long term survivor (≥ 48 months) of 100%, 83% and 0.948 respectively. Using a cutoff of < 10/13, this score was significantly correlated to PFS and OS (p< 0.001 both). In conclusion, geriatric predictive factors may contribute to the elderly management improvement: the brain geriatric score must now be validated in a prospective independent cohort including IDHm and IDHwt elderly patients.

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Plasma levels of IL-8 and g-CSF in high-grade gliomas treated with bevacizumab.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.2083 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 2083-2083 ◽

Cited By ~ 2

Author(s):

Marica Eoli ◽

Cristina Rabascio ◽

Lucia Cuppini ◽

Elena Anghileri ◽

Serena Pellegatta ◽

...

Keyword(s):

Plasma Levels ◽

Significant Activity ◽

High Grade ◽

Healthy Controls ◽

Comparison Results ◽

Number Of Patients ◽

High Grade Gliomas ◽

Treatment Onset

2083 Background: Bevacizumab, an anti-VEGF antibody, has shown significant activity in high grade gliomas (HGG). However, tumor recurrence inevitably occurs. Methods: We treated 63 recurrent HGG patients with poor prognostic factors with bevacizumab (10 mg/kg) and irinotecan (125 or 340 mg/m2) every 2 weeks, and investigated IL-12, IL-13, IL-17, FGF basic, G-CSF, MIP-1b, PDGF-beta, plasma levels before starting treatment and every 8 weeks by Bioplex. Ten age- and sex-matched healthy controls were used for comparison. Results: After a median follow-up of 27 weeks, median OS and PFS were 33 and 18 weeks, respectively. PFS at 6 and 12 months were 32% and 12%, respectively. OS at 6 months was 60%. Toxicity was mild. Baseline higher amounts of IL-13 (48±174 pg/ml vs 3.44±0.9 pg/ml, p=0.0001) and lower amounts of MIP-1b (35.3±20.9 pg/ml vs 67.2±18.8 pg/ml, p=0.0002), PDGF-beta (1585.5±1585 pg/ml vs 7098±1585 pg/ml, p=0.0001) and VEGF (27±39.8 pg/ml vs 54.5±32 pg/ml, p=0.001) were detected in patients than in healthy controls. In a cohort of 15 non-responders (patients who progressed 8 weeks after treatment onset), baseline IL-8 (15.7±10.8 pg/ml vs 10.9±9.4 pg/ml, p=0.03) and G-CSF (113.3±54 pg/ml vs 84.9±59.2 pg/ml, p=0.03) were significantly higher than in patients responding to treatment. In the same cohort no significant reduction of VEGF and other cytokines was observed after 8 weeks of treatment, while a decrease of plasma VEGF was observed in the remaining patients (26±32 pg/ml vs 13.3±28.5 pg/ml, p=0.001). Furthermore, in a cohort of 22 long-term responders (patients who progressed after more than 18 weeks of treatment), levels of VEGF decreased after 8 weeks of treatment when compared to baseline, whereas no difference was observed in baseline levels (23.9±22.6 pg/ml vs 9.8±9.4 pg/ml, p=0.001). Conclusions: Data suggest that high levels of IL-8 and G-CSF at baseline associated with a lack of VEGF decrease after 8 weeks of treatment identify patients who are resistant to bevacizumab. This hypothesis should be tested in a large number of patients.

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