Guideline Conformity to the Stupp Regimen in Patients with Newly Diagnosed Glioblastoma Multiforme in China

Qiu

Computational and Mathematical Methods in Medicine

et al. 2022

Objective. This study is aimed at analyzing the factors affecting the recurrence patterns and recurrence-free survival (RFS) of high-grade gliomas (HGG). Methods. Eligible patients admitted to the Affiliated Hospital of Xuzhou Medical University were selected. Subsequently, the effects of some clinical data including age, gender, WHO pathological grades, tumor site, tumor size, clinical treatments, and peritumoral edema (PTE) area and molecular markers (Ki-67, MGMT, IDH-1, and p53) on HGG patients’ recurrence patterns and RFS were analyzed. Results. A total number of 77 patients were enrolled into this study. After analyzing all the cases, it was determined that tumor size and tumor site had a significant influence on the recurrent patterns of HGG, and PTE was an independent predict factor of recurrence patterns. Specifically, when the PTE was mild (<1 cm), the recurrence pattern tended to be local; in contrast, HGG was more likely to progress to marginal recurrence and distant recurrence. Furthermore, age and PTE were significantly associated with RFS; the median RFS of the population with PTE < 1 cm (23.60 months) was obviously longer than the population with PTE ≥ 1 cm (5.00 months). Conclusions. PTE is an independent predictor of recurrence patterns and RFS for HGG. Therefore, preoperative identification of PTE in HGG patients is crucially important, which is helpful to accurately estimate the recurrence pattern and RFS.

Section: Introductionmentioning

confidence: 99%

Peritumor Edema Serves as an Independent Predictive Factor of Recurrence Patterns and Recurrence-Free Survival for High-Grade Glioma

Qiu

Computational and Mathematical Methods in Medicine

et al. 2022

Surgical Neurology International

“…The current treatment of all newly diagnosed GBM patients is cytoreductive surgery (>98%), followed by the Stupp regimen (fractionated focal irradiation in daily fractions of 2 Gy given 5 days/week for 6 weeks (a total of 60 Gy), plus concomitant daily temozolomide (75 mg/m 2 /day, 7 days/week from the first to the last day of radiotherapy), followed by six cycles of adjuvant temozolomide (150–200 mg/m 2 /day for 5 days during each 28-day cycle). [ 18 ]…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Glioblastoma multiforme at internal auditory canal

Zaidi

Amanullah

Jafri³

et al. 2023

Background: Glioblastomas are the most common adult primary brain tumor present supratentorially. The presence of true extra-axial GBM infratentorially, especially in the internal auditory canal, is extremely rare with only three cases reported previously in the literature. We report the fourth case of primary internal auditory canal/cerebellopontine angle (CPA) glioblastoma which initially mimicked vestibular schwannoma on the basis of its location and presentation. Case Description: A 65-year-old male presented with headache, vertigo, and progressive right ear deafness for 5 months. His preoperative magnetic resonance imaging findings were consistent with vestibular schwannoma. Maximum safe resection (near total) was done. The final histopathology report showed glioblastoma multiforme. Conclusion: As per our knowledge, this is the fourth reported case of an extra-axial VIII cranial nerve glioblastoma located in internal auditory canal. Hence, despite being very rare, they should be considered as a differential in tumors at CPA.

“…Treatment with postoperative chemoradiotherapy is currently the standard of care for glioblastoma. Even though some patients may benefit from the Stupp regimen [2], the overall prognosis remains poor [3], with less than 10% survivorship at 5 years [4]. At present, prognostic predictions for patients with glioblastoma are mainly made based on patient age, Karnofsky Performance Status (KPS), prior treatment, resection range, methylation of O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation status, isocitrate dehydrogenase genes (IDH), telomerase reverse transcriptase (TERT), and other molecular markers, such as alpha thalassemia/ mental retardation syndrome X-linked (ATRX) gene [5,6].…”

Section: Introductionmentioning

confidence: 99%

The prognostic significance of tumor-associated neutrophils and circulating neutrophils in glioblastoma (WHO CNS5 classification)

Wang

et al. 2023

BMC Cancer

Background Tumor-associated neutrophils (TANs) in the tumor microenvironment are prognostic biomarkers in many malignancies. However, it is unclear whether TANs can serve as a prognostic marker for clinical outcomes in patients with glioblastoma (GBM), as classified according to World Health Organization Classification of Tumors of the Central Nervous System, fifth edition (CNS5). In the present study, we analyzed correlations of TANs and peripheral blood neutrophils prior to radiotherapy with overall survival (OS) in GBM (CNS5). Methods RNA-seq expression profiles of patients with newly diagnosed GBM (CNS5) were extracted from The Cancer Genome Atlas (TCGA), and The Chinese Glioma Genome Atlas (CGGA). TAN infiltration was inferred using CIBERSORTx algorithm. Neutrophil counts prior to radiotherapy in newly diagnosed GBM (CNS5) were obtained from the First Affiliated Hospital of Fujian Medical University. The prognostic value of TANs and peripheral blood neutrophils before radiotherapy was investigated using Kaplan-Meier analysis and Cox proportional hazards models. The robustness of these findings was evaluated by sensitivity analysis, and E values were calculated. Results A total of 146 and 173 individuals with GBM (CNS5) were identified from the TCGA and CGGA cohorts, respectively. High infiltration of TANs was of prognostic of poor OS in TCGA (HR = 1.621, 95% CI: 1.004–2.619) and CGGA (HR = 1.546, 95% CI: 1.029–2.323). Levels of peripheral blood neutrophils before radiotherapy (HR = 2.073, 95% CI: 1.077–3.990) were independently associated with poor prognosis. Sensitivity analysis determined that the E-value of high TANs infiltration was 2.140 and 2.465 in the TCGA and CGGA cohorts. Conclusions TANs and peripheral blood neutrophil levels before radiotherapy are prognostic of poor outcomes in GBM (CNS5).