An Early and Rare Second Malignancy in A Treated Glioblastoma Multiforme: Is It Radiation or Temozolomide?

Goyal, Snigdha; Singh, Rabi Raja; Balukrishna, Sasidharan; Bindra, Mandeep Singh; Backianathan, Selvamani

doi:10.7860/jcdr/2015/13588.5833

Cited by 3 publications

(15 citation statements)

References 20 publications

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“…Nine studies (10 patient cases) were immediately included in the review. [24][25][26][27][28][29][30][31][32] A metaanalysis was identified 33 which included two relevant case reports from studies not identified in the initial search; these two case reports were also included. 34,35 One study which described two additional relevant case reports was also identified by screening the references of included studies.…”

Section: Resultsmentioning

confidence: 99%

Sinonasal Malignancy Following Cranial Irradiation: A Scoping Review and Case Report of Sinonasal Teratocarcinosarcoma

Levy,

Biasio,

Toledo

et al. 2024

J Neurol Surg Rep

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Background Radiation therapy is a mainstay of treatment for brain tumors, but delayed complications include secondary malignancy which may occur months to years after treatment completion. Methods We reviewed the medical records of a 41-year-old female treated with 60 Gy of radiation for a recurrent astrocytoma, who 6 years later developed a locally advanced sinonasal teratocarcinosarcoma. We searched MEDLINE, Embase, and Web of Science to conduct a scoping review of biopsy-proven sinonasal malignancy in patients who previously received cranial irradiation for a brain tumor. Results To our knowledge, this is the first report of a patient to present with a sinonasal teratocarcinosarcoma after receiving irradiation for a brain tumor. Our scoping review of 1,907 studies produced 14 similar cases of secondary sinonasal malignancy. Median age of primary cancer diagnosis was 39.5 years old (standard deviation [SD]: 21.9), and median radiation dose was 54 Gy (SD: 20.3). Median latency time between the primary cancer and secondary sinonasal cancer was 9.5 years (SD: 5.8). Olfactory neuroblastoma was the most common sinonasal cancer (n = 4). Fifty percent of patients died from their sinonasal cancer within 1.5 years. Conclusion Patients who receive radiation exposure to the sinonasal region for treatment of a primary brain tumor, including low doses or scatter radiation, may be at risk of a secondary sinonasal malignancy later in life. Physicians who monitor at-risk patients must be vigilant of symptoms which may suggest sinonasal malignancy, and surveillance should include radiographic review with careful monitoring for a secondary malignancy throughout the entire irradiated field.

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Section: Resultsmentioning

confidence: 99%

Sinonasal Malignancy Following Cranial Irradiation: A Scoping Review and Case Report of Sinonasal Teratocarcinosarcoma

Levy,

Biasio,

Toledo

et al. 2024

J Neurol Surg Rep

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“…Glioblastoma multiforme (GBM) is the most common and aggressive primary brain tumor among adults, with an average survival of approximately 15 months. , The standard protocol available for the treatment of GBM consists of maximal safe surgical resection, followed by radiotherapy, plus concomitant and adjuvant chemotherapy with the alkylating agent temozolamide (TMZ). , However, at least 50% of TMZ-treated patients do not respond to this agent. Moreover, hematological malignancies such as acute lymphoblastic leukemia, acute myeloid leukemia and myelodysplastic syndrome have been reported to occur after treatment with TMZ. − …”

Section: Results and Discussionmentioning

confidence: 99%

“…Importantly, hTP is overexpressed in GBM, whereas undetectable or trace levels are found in the normal human brain. − The occurrences of microvascular proliferation, invasion, and resistance to apoptosis are hallmarks of glioblastoma. , Antiangiogenic therapy is considered an important target for GBM treatment, and several clinical trials enrolling antiangiogenic agents are in progress. ,− The novel strategies for GBM treatment are focused on the modulation of vessel permeability, hypoxia, and tumor-induced edema. ,, …”

Section: Results and Discussionmentioning

confidence: 99%

“…52 novel strategies for GBM treatment are focused on the modulation of vessel permeability, hypoxia, and tumor-induced edema. 54,58,60 Pharmacokinetic studies were performed in mice after intraperitoneal (IP) administration of 8g (50 mg/kg) (Table 2). Maximum plasma concentration (C max ) of 34.8 μg/mL was achieved after 0.08 h (T max ).…”

Section: Early Toxicity and In Vitro Metabolic Stabilitymentioning

confidence: 99%

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Design of Novel Inhibitors of Human Thymidine Phosphorylase: Synthesis, Enzyme Inhibition, in Vitro Toxicity, and Impact on Human Glioblastoma Cancer

Sperotto¹,

Roth²,

Rodrigues-Junior³

et al. 2019

J. Med. Chem.

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Overexpressed human thymidine phosphorylase (hTP) has been associated with cancer aggressiveness and poor prognosis by triggering proangiogenic and antiapoptotic signaling. Designed as transition-state analogues by mimicking the oxacarbenium ion, novel pyrimidine-2,4-diones were synthesized and evaluated as inhibitors of hTP activity. The most potent compound (8g) inhibited hTP in the submicromolar range with a noncompetitive inhibition mode with both thymidine and inorganic phosphate substrates. Furthermore, compound 8g was devoid of apparent toxicity to a panel of mammalian cells, showed no genotoxicity signals, and had low probability of drug–drug interactions and moderate in vitro metabolic rates. Finally, treatment with 8g (50 mg/(kg day)) for 2 weeks (5 days/week) significantly reduced tumor growth using an in vivo glioblastoma model. To the best of our knowledge, this active compound is the most potent in vitro hTP inhibitor with a kinetic profile that cannot be reversed by the accumulation of any enzyme substrates.

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“…Goyal et al 10 reported a case of a sinonasal carcinoma occurring 1.5 years post-GBM radiotherapy treatment and outside the radiation field, however, in that case, due to the short interval time, radiation therapy was unlikely to be the cause of the second malignancy and therefore the malignancy did not meet Cahan's criteria. The case we have described here presents a rare event whereby the criteria for a radiation-induced tumour were met, due to the patient surviving significantly longer than would otherwise be expected following surgical treatment of GBM.…”

Section: Discussionmentioning

confidence: 99%

Rare case of radiation-induced trigeminal schwannoma occurring in a long-term glioblastoma multiforme survivor

Shalchi¹,

Hussain

Giridharan

et al. 2016

BMJ Case Reports

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Glioblastoma multiforme (GBM) is a high-grade primary brain tumour with a notably poor prognosis. Research demonstrates a median survival of just over 1 year following aggressive treatment. Long-term survival is notably rare. Cranial radiotherapy and postexcisional prophylactic treatment is associated with the development of second, histologically distinct tumours in rare cases. Radiation-induced intracranial schwannomas are uncommon, with only a small number of cranial nerve schwannoma cases reported in recent decades. To our knowledge, this is the first reported case of a radiation-induced benign trigeminal schwannoma occurring following long-term survival from glioblastoma. Here we present (1) a rare case of 14-year survival following treatment of a right parietal glioblastoma and the development of a radiation-induced benign trigeminal schwannoma in a 35-year-old man, and (2) a review of radiation-induced schwannoma cases reported in the existing literature.

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An Early and Rare Second Malignancy in A Treated Glioblastoma Multiforme: Is It Radiation or Temozolomide?

Cited by 3 publications

References 20 publications

Sinonasal Malignancy Following Cranial Irradiation: A Scoping Review and Case Report of Sinonasal Teratocarcinosarcoma

Sinonasal Malignancy Following Cranial Irradiation: A Scoping Review and Case Report of Sinonasal Teratocarcinosarcoma

Design of Novel Inhibitors of Human Thymidine Phosphorylase: Synthesis, Enzyme Inhibition, in Vitro Toxicity, and Impact on Human Glioblastoma Cancer

Rare case of radiation-induced trigeminal schwannoma occurring in a long-term glioblastoma multiforme survivor

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