A preliminary retrospective study with temozolomide and radiotherapy versus radiotherapy alone for the treatment of high-grade gliomas

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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Diagnosis and management of multiple high-grade gliomas: a retrospective study

10.21203/rs.2.349/v1 ◽

2019 ◽

Author(s):

Yang Gao ◽

Hui Zheng ◽

Liangdong Li ◽

Changshuai Zhou ◽

Xin Chen ◽

...

Keyword(s):

Retrospective Study ◽

Survival Time ◽

Dna Methyltransferase ◽

Therapeutic Strategies ◽

Karnofsky Performance Scale ◽

Subtotal Resection ◽

Surgical Removal ◽

High Grade ◽

Survival Group ◽

High Grade Gliomas

Abstract Background: Multiple high-grade gliomas (M-HGG) are uncommon lesions in the central nervous system. The management is controversial and the prognosis remains unfavorable. The aim of this study is to identify the characteristics of M-HGG and explore more appropriate therapeutic strategies for patients. Methods: A retrospective study was performed on 15 patients who were treated with M-HGG between August 2016 and March 2018 in our hospital. Clinical data including age, sex, Karnofsky Performance Scale (KPS) scores, number and location of lesions, surgical approach, pathology, adjuvant therapy (radio or chemotherapy) and prognosis were collected. Results: The most frequent position of tumors was temporal lobe, followed by frontal and occipital lobe. Patients who underwent surgical removal (gross total resection or subtotal resection) showed longer survival time than that in biopsy group (p < 0.05). The index of Ki-67 was higher (36.11 ± 1.8 vs 22.33 ± 2.1, p < 0.05) and the KPS score was lower (60.00 ± 2.7 vs 82.86 ± 2.9, p < 0.05) in death group than that in survival group. Two patients presented with different pathological grades: GBM (WHO IV), anaplastic astrocytoma (WHO III). Four patients presenting with methylation of genes of O-6-methylguanine DNA methyltransferase (MGMT) were still alive. No IDH1 mutation was detected in all cases. Eight patients died during follow-up, and the average survival period was 11.2 months. The survival time of living patients was more than 15.9 months. Conclusions: Surgical removal of dominant tumors of M-GBM is recommended, and stereotactic biopsy can achieve pathologic diagnosis if surgical removal is inaccessible. Comprehensive analysis of the clinical features and molecular pathology of multiple gliomas is helpful to find more effective diagnostic and therapeutic strategies.

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Retrospective study of nivolumab for patients with recurrent high grade gliomas

Journal of Neuro-Oncology ◽

10.1007/s11060-018-2907-4 ◽

2018 ◽

Vol 139 (3) ◽

pp. 625-631 ◽

Cited By ~ 7

Author(s):

Megan Mantica ◽

Ashley Pritchard ◽

Frank Lieberman ◽

Jan Drappatz

Keyword(s):

Retrospective Study ◽

High Grade ◽

High Grade Gliomas

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Association between supratentorial pediatric high-grade gliomas involved with the subventricular zone and decreased survival: a multi-institutional retrospective study

Journal of Neurosurgery Pediatrics ◽

10.3171/2020.3.peds19593 ◽

2020 ◽

Vol 26 (3) ◽

pp. 288-294

Author(s):

Akshitkumar M. Mistry ◽

Nishit Mummareddy ◽

Travis S. CreveCoeur ◽

Jock C. Lillard ◽

Brandy N. Vaughn ◽

...

Keyword(s):

Retrospective Study ◽

Subventricular Zone ◽

Tumor Volume ◽

Pediatric Population ◽

High Grade Glioma ◽

The United States ◽

High Grade ◽

Total Resection ◽

Who Grade ◽

High Grade Gliomas

OBJECTIVEThe subventricular zone (SVZ), housed in the lateral walls of the lateral ventricles, is the largest neurogenic niche in the brain. In adults, high-grade gliomas in contact or involved with the SVZ are associated with decreased survival. Whether this association holds true in the pediatric population remains unexplored. To address this gap in knowledge, the authors conducted this retrospective study in a pediatric population with high-grade gliomas treated at three comprehensive centers in the United States.METHODSThe authors retrospectively identified 63 patients, age ≤ 21 years, with supratentorial WHO grade III–IV gliomas treated at three academic centers. Basic demographic and clinical data regarding presenting signs and symptoms and common treatment variables were obtained. Preoperative MRI studies were evaluated to assess SVZ contact by tumor and to quantify tumor volume.RESULTSSixty-three patients, including 34 males (54%), had a median age of 12.3 years (IQR 6.50–16.2) and a median tumor volume of 39.4 ml (IQR 19.4–65.8). Tumors contacting the SVZ (SVZ+) were noted in 34 patients (54%) and overall were larger than those not in contact with the SVZ (SVZ−; 51.1 vs 27.3, p = 0.002). The SVZ+ tumors were also associated with decreased survival. However, age, tumor volume, tumor grade, and treatment with chemotherapy and/or radiation were not associated with survival in the 63 patients. In the univariable analysis, near-total resection, gross-total resection, and seizure presentation were associated with increased survival (HR = 0.23, 95% CI 0.06–0.88, p = 0.03; HR = 0.26, 95% CI 0.09–0.74, p = 0.01; and HR = 0.46, 95% CI 0.22–0.97, p = 0.04, respectively). In a multivariable stepwise Cox regression analysis, only SVZ+ tumors remained significantly associated with decreased survival (HR = 1.94, 95% CI 1.03–3.64, p = 0.04).CONCLUSIONSHigh-grade glioma contact with the SVZ neural stem cell niche was associated with a significant decrease in survival in the pediatric population, as it is in the adult population. This result suggests that tumor contact with the SVZ is a general negative prognosticator in high-grade glioma independent of age group and invites biological investigations to understand the SVZ’s role in glioma pathobiology.

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Prevalence and clinicopathological features of H3.3 G34-mutant high-grade gliomas: a retrospective study of 411 consecutive glioma cases in a single institution

Brain Tumor Pathology ◽

10.1007/s10014-017-0287-7 ◽

2017 ◽

Vol 34 (3) ◽

pp. 103-112 ◽

Cited By ~ 21

Author(s):

Koji Yoshimoto ◽

Ryusuke Hatae ◽

Yuhei Sangatsuda ◽

Satoshi O. Suzuki ◽

Nobuhiro Hata ◽

...

Keyword(s):

Retrospective Study ◽

Clinicopathological Features ◽

High Grade ◽

Single Institution ◽

High Grade Gliomas

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P14.13 Incidence of pseudoprogression in high-grade IDH-mutant gliomas

Neuro-Oncology ◽

10.1093/neuonc/noz126.248 ◽

2019 ◽

Vol 21 (Supplement_3) ◽

pp. iii69-iii69

Author(s):

A SEYVE ◽

S Cartalat ◽

D Meyronet ◽

A D’hombres ◽

M Barritault ◽

...

Keyword(s):

Consecutive Series ◽

High Grade ◽

Study Population ◽

Radiotherapy Alone ◽

Independent Series ◽

High Grade Gliomas ◽

Pcv Chemotherapy ◽

Timing Of Onset ◽

True Progression

Abstract BACKGROUND Pseudoprogression (PsP) is a well-known concern in IDH-wildtype glioblastomas. The aim of the present study was to describe its incidence in high-grade IDH-mutant gliomas. MATERIAL AND METHODS We retrospectively analyzed the characteristics of a consecutive series of high-grade IDH-mutant gliomas treated with radiotherapy (RT) with or without chemotherapy between March 2009 and September 2017. PsP was defined as a new enhanced lesion that occurred after RT and subsequently disappeared or remained stable during follow-up for a least 6 months. RESULTS The study population consisted of 38 anaplastic IDH-mutant and 1p/19q codeleted oligodendrogliomas, 34 IDH-mutant anaplastic astrocytomas and 18 IDH-mutant glioblastomas. Treatment consisted of radiotherapy alone (n=8, 9%), radiotherapy and PCV chemotherapy (n=63, 70%) and temozolomide radiochemotherapy (n=19, 21%). After a median follow-up of 3.5 years (range 1–8 years), 24 patients (28%) presented a PsP that occurred after a median delay of 10 months after radiotherapy (2 to 32 months). PsP was more frequent in patients treated with RT+PCV than in those treated with RT+TMZ (34% vs 10%, p=0.05). During the first two years after RT completion, 19 patients (21%) presented a PsP and 15 patients (17%) a true progression. At last follow-up, 1 patient (4%) in the PsP group had died compared to 10 patients (16%) in the group of patients without PsP. CONCLUSION PsP is a frequent issue in IDH-mutant high-grade gliomas. Its timing of onset is delayed compared to the timing of PsP onset reported in IDH-wildtype glioblastomas. The association between the use of PCV chemotherapy and PsP requires validation in an independent series.

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