Significance of H3K27M Mutation in "Nonmidline" High-Grade Gliomas of Cerebral Hemispheres

2019 ◽  
Vol 131 ◽  
pp. 174-176 ◽  
Author(s):  
Giuseppe La Rocca ◽  
Giovanni Sabatino ◽  
Roberto Altieri ◽  
Francesco Signorelli ◽  
Luca Ricciardi ◽  
...  
Keyword(s):  
Cerebral Hemispheres ◽  
High Grade ◽  
High Grade Gliomas ◽  
H3k27m Mutation

RADT-09. ROLE OF RADIOTHERAPY IN MANAGEMENT OF PRIMARY SPINAL HIGH GRADE GLIOMA: A SINGLE INSTITUTION RETROSPECTIVE ANALYSIS

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi42-vi43
Author(s):  
Rituraj Upadhyay ◽  
Swapnil Khose ◽  
Halyna Pokhylevych ◽  
Arnold dela Cruz Paulino ◽  
Mary Frances McAleer ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Univariate Analysis ◽  
Concurrent Chemotherapy ◽  
Leptomeningeal Disease ◽  
High Grade ◽  
Single Institution ◽  
Who Grade ◽  
Mgmt Promoter ◽  
High Grade Gliomas ◽  
H3k27m Mutation

Abstract BACKGROUND Primary spinal high-grade gliomas(S-HGG) are rare, aggressive tumors and radiation therapy(RT) plays a dominant role in the management given their infiltrative nature. We conducted a single-institution retrospective review to study the clinicopathological features and management of S-HGGs. METHODS Patients with biopsy-proven S-HGG who received RT from 2001-2020 were analyzed for patient, tumor, and treatment characteristics. Kaplan-Meier estimate and Cox proportional hazard regression method were used for survival analyses. RESULTS Twenty-nine patients were identified with a median age of 25.9 years (range 1-74y). Four patients had gross total resection(GTR) while 25 underwent subtotal resection or biopsy. Nineteen patients had WHO grade 4 tumor. IDH1 mutation and MGMT promoter methylation were analyzed in 14 and four patients respectively; all were IDH wildtype and MGMT-promoter unmethylated. H3K27M mutation was present in five out of 10 patients tested. Twenty-two patients received photon-based radiation and 7 received proton therapy. Median RT dose was 50.4 Gy (range 39.6-54Gy) with 79% receiving >45Gy. 65% patients received concurrent chemotherapy, most commonly temozolomide. Twenty-three (79%) patients had documented recurrence. Overall, 16 patients relapsed locally, 10 relapsed in the brain and 8 developed leptomeningeal disease; only 8(35%) had isolated local relapse. Median OS from diagnosis was 21.3 months and median PFS after RT was 9.7 months. On univariate analysis, age, sex, GTR, grade, RT modality, RT dose and concurrent chemotherapy did not predict for survival. Patients with H3K27M mutation had a poorer median PFS after RT compared to those without the mutation but the difference did not reach statistical significance (p = 0.26). CONCLUSIONS Although 86% of patients had gross disease at RT and received a lower median RT dose than typically used in cerebral high-grade gliomas, only 55% of patients failed locally. H3K27M mutation may portend worse survival; future studies to improve the therapeutic approach in these patients are warranted.

Venous Thromboembolism and High Grade Gliomas

1993 ◽  
Vol 70 (03) ◽  
pp. 393-396 ◽  
Author(s):  
Mandeep S Dhami ◽  
Robert D Bona ◽  
John A Calogero ◽  
Richard M Hellman
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Medical Center ◽  
Significant Risk ◽  
Bleeding Complications ◽  
Fisher Exact Test ◽  
High Grade ◽  
Chi Square ◽  
Exact Test ◽  
High Grade Gliomas

SummaryA retrospective study was done to determine the incidence of and the risk factors predisposing to clinical venous thromboembolism (VTE) in patients treated for high grade gliomas. Medical records of 68 consecutive patients diagnosed and treated at Saint Francis Hospital and Medical Center from January 1986 to June 1991 were reviewed. The follow up was to time of death or at least 6 months (up to December 1991). All clinically suspected episodes of VTE were confirmed by objective tests. Sixteen episodes of VTE were detected in 13 patients for an overall episode rate of 23.5%. Administration of chemotherapy (p = 0.027, two tailed Fisher exact test) and presence of paresis (p = 0.031, two tailed Fisher exact test) were statistically significant risk factors for the development of VTE. Thrombotic events were more likely to occur in the paretic limb and this difference was statistically significant (p = 0.00049, chi square test, with Yates correction). No major bleeding complications were seen in the nine episodes treated with long term anticoagulation.We conclude that venous thromboembolic complications are frequently encountered in patients being treated for high grade gliomas and the presence of paresis and the administration of chemotherapy increases the risk of such complications.

A Prospective Validation Study of the First 3D Digital Exoscope for Visualization of 5-ALA–Induced Fluorescence in High-Grade Gliomas

2021 ◽  
Author(s):  
Michael A. Vogelbaum ◽  
Derek Kroll ◽  
Arnold Etame ◽  
Nam Tran ◽  
James Liu ◽  
...  
Keyword(s):  
Validation Study ◽  
High Grade ◽  
High Grade Gliomas
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