scholarly journals Peritumoral Microenvironment in High-Grade Gliomas: From FLAIRectomy to Microglia–Glioma Cross-Talk

2021 ◽  
Vol 11 (2) ◽  
pp. 200
Author(s):  
Roberto Altieri ◽  
Davide Barbagallo ◽  
Francesco Certo ◽  
Giuseppe Broggi ◽  
Marco Ragusa ◽  
...  
Keyword(s):  
Cross Talk ◽  
Near Infrared ◽  
Biologically Active ◽  
High Grade ◽  
Microglia Polarization ◽  
M1 Phenotype ◽  
High Grade Gliomas ◽  
Patient’S Outcome ◽  
Tumor Edge

Cellular composition and molecular signatures of the glioma core compared with infiltrative margins are different, and it is well known that the tumor edge is enriched in microglia. In this review of the literature, we summarize the role of the peritumoral area in high-grade gliomas (HGGs) from surgical and biological points of view. There is evidence on the dual role of microglia in HGGs—a scavenger-tumoricidal role when microglia are activated in an M1 phenotype and a role favoring tumor growth and infiltration/migration when microglia are activated in an M2 phenotype. Microglia polarization is mediated by complex pathways involving cross-talk with glioma cells. In this scenario, extracellular vesicles and their miRNA cargo seem to play a central role. The switch to a specific phenotype correlates with prognosis and the pathological assessment of a specific microglial setting can predict a patient’s outcome. Some authors have designed an engineered microglial cell as a biologically active vehicle for the delivery of intraoperative near-infrared fluorescent dye with the aim of helping surgeons detect peritumoral infiltrated areas during resection. Furthermore, the pharmacological modulation of microglia-glioma cross-talk paves the way to more effective therapies.

scholarly journals Stereotactic Laser Interstitial Thermal Therapy for Recurrent High-Grade Gliomas

Neurosurgery ◽  
2016 ◽  
Vol 79 (suppl_1) ◽  
pp. S24-S34 ◽  
Author(s):  
Ian Lee ◽  
Steven Kalkanis ◽  
Constantinos G. Hadjipanayis
Keyword(s):  
Thermal Therapy ◽  
Neurological Deficits ◽  
Current Evidence ◽  
High Grade ◽  
Medline Search ◽  
Laser Interstitial Thermal Therapy ◽  
Ablation Volume ◽  
Treatment Paradigm ◽  
High Grade Gliomas

Abstract BACKGROUND: The value of maximal safe cytoreductive surgery in recurrent high-grade gliomas (HGGs) is gaining wider acceptance. However, patients may harbor recurrent tumors that may be difficult to access with open surgery. Laser interstitial thermal therapy (LITT) is emerging as a technique for treating a variety of brain pathologies, including primary and metastatic tumors, radiation necrosis, and epilepsy. OBJECTIVE: To review the role of LITT in the treatment of recurrent HGGs, for which current treatments have limited efficacy, and to discuss the possible role of LITT in the disruption of the blood-brain barrier to increase delivery of chemotherapy locoregionally. METHODS: A MEDLINE search was performed to identify 17 articles potentially appropriate for review. Of these 17, 6 reported currently commercially available systems and as well as magnetic resonance thermometry to monitor the ablation and, thus, were thought to be most appropriate for this review. These studies were then reviewed for complications associated with LITT. Ablation volume, tumor coverage, and treatment times were also reviewed. RESULTS: Sixty-four lesions in 63 patients with recurrent HGGs were treated with LITT. Frontal (n = 34), temporal (n = 14), and parietal (n = 16) were the most common locations. Permanent neurological deficits were seen in 7 patients (12%), vascular injuries occurred in 2 patients (3%), and wound infection was observed in 1 patient (2%). Ablation coverage of the lesions ranged from 78% to 100%. CONCLUSION: Although experience using LITT for recurrent HGGs is growing, current evidence is insufficient to offer a recommendation about its role in the treatment paradigm for recurrent HGGs.

scholarly journals Is There an Independent Role of TERT and NF1 in High Grade Gliomas?

2020 ◽  
Vol 13 (2) ◽  
pp. 346-354 ◽  
Author(s):  
Evangelia Razis ◽  
Vassiliki Kotoula ◽  
Georgia-Angeliki Koliou ◽  
Kyriaki Papadopoulou ◽  
Eleni Vrettou ◽  
...  
Keyword(s):  
High Grade ◽  
High Grade Gliomas

scholarly journals Is it time to reconsider the role of irinotecan for the treatment of high-grade gliomas?

2018 ◽  
Vol 20 (8) ◽  
pp. 1144-1144 ◽  
Author(s):  
Eudocia Quant Lee ◽  
J Ricardo McFaline-Figueroa ◽  
Timothy F Cloughesy ◽  
Patrick Y Wen
Keyword(s):  
High Grade ◽  
High Grade Gliomas

The Role of Adjuvant Radiation Therapy in the Management of High-Grade Gliomas

2012 ◽  
Vol 23 (2) ◽  
pp. 247-258 ◽  
Author(s):  
Joshua J. Wind ◽  
Richard Young ◽  
Ashima Saini ◽  
Jonathan H. Sherman
Keyword(s):  
Radiation Therapy ◽  
Adjuvant Radiation ◽  
High Grade ◽  
Adjuvant Radiation Therapy ◽  
High Grade Gliomas

scholarly journals With a Little Help from My Friends: The Role of Intraoperative Fluorescent Dyes in the Surgical Management of High-Grade Gliomas

2018 ◽  
Vol 8 (2) ◽  
pp. 31 ◽  
Author(s):  
Rosario Maugeri ◽  
Alessandro Villa ◽  
Mariangela Pino ◽  
Alessia Imperato ◽  
Giuseppe Giammalva ◽  
...  
Keyword(s):  
Surgical Management ◽  
Fluorescent Dyes ◽  
High Grade ◽  
High Grade Gliomas

High-grade gliomas in children and adolescents: is there a role for reoperation?

2020 ◽  
pp. 1-10
Author(s):  
Marcos Devanir Silva da Costa ◽  
Nicole Cavalari Camargo ◽  
Patricia Alessandra Dastoli ◽  
Jardel Mendonça Nicácio ◽  
Frederico Adolfo Benevides Silva ◽  
...  
Keyword(s):  
Adjuvant Treatment ◽  
Treatment Initiation ◽  
Tumor Resection ◽  
Therapeutic Interventions ◽  
High Morbidity ◽  
High Grade ◽  
Ki 67 ◽  
Significant Difference ◽  
High Grade Gliomas

OBJECTIVETumors of the CNS are the main causes of childhood cancer and have an incidence that exceeds that of leukemia. In addition, they are the leading causes of cancer-related death in childhood. High-grade gliomas account for 11% of such neoplasms and are characterized by aggressive clinical behavior and high morbidity and mortality. There is a lack of studies focusing on the factors that can prolong survival in these patients or guide therapeutic interventions. The authors aimed to investigate the factors related to longer survival durations, with a focus on reoperation for gross-total resection (GTR).METHODSIn this retrospective cohort study, the authors analyzed 78 patients diagnosed with high-grade gliomas occurring across all CNS locations except diffuse intrinsic pontine gliomas. Patients 0 to < 19 years of age were followed up at the Pediatric Oncology Institute. Overall survival (OS) and progression-free survival (PFS) were analyzed in the context of various prognostic factors, such as age, sex, histology, extent of tumor resection, reoperation for GTR, adjuvant treatment, and treatment initiation from 2010 onward.RESULTSWith a mean age at diagnosis of 8.7 years, 50% of the patients were female and approximately 39% underwent GTR at some point, which was already achieved in approximately 46% of them in the first surgery. The median OS was 17 months, and PFS was 10 months. In terms of median OS, the authors found no significant difference between those with reoperation for GTR and patients without GTR during treatment. Significant differences were observed in the OS in terms of the extent of resection in the first surgery, age, sex, Ki-67 expression, adjuvant treatment, and treatment initiation from 2010 onward. Furthermore, the PFS values significantly differed between those with GTR in the first surgery and Ki-67 expression ≥ 50%.CONCLUSIONSThis study demonstrates the importance of GTR for these neoplasms, highlights the role of surgeons in its achievement in the first attempt, and questions the role of reoperation for this purpose. Finally, this study further supports the use of combined adjuvant treatment for the improvement of OS and PFS.

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