Canadian brain cancer survival rates by tumour type and region: 1992–2008

Yuan, Yan; Li, Maoji; Nagamuthu, Chenthila; Andres, E.; Davis, Faith G.

doi:10.17269/cjph.107.5209

Cited by 16 publications

(19 citation statements)

References 16 publications

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“…Glioma of adult onset are heterogeneous in their subtypes and behaviour; however, the overall prognosis of these tumours even after induction of early remission is poor . This is exemplified by our data, which show 41.4% of individuals in this study to have deceased at a mean follow‐up of 8.2 years.…”

Section: Discussionmentioning

confidence: 56%

“…The effects of cranial radiotherapy (cXRT) on pituitary function have been well studied in cancer survivors of childhood onset; however, the consequences of cXRT on pituitary function have been less well characterized in individuals with adult‐onset brain tumours . Adult‐onset and childhood‐onset brain tumours behave differently, with adult‐onset tumours being more aggressive and associated with a significantly higher rate of relapse and mortality . Similarly, endocrinologically, there appears to be a dichotomy in the radio‐sensitivity of the hypothalamic‐pituitary (HP) axis of adults and children, with children showing greater susceptibility to radiation‐induced hypopituitarism.…”

Section: Introductionmentioning

confidence: 99%

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Hypothalamic‐pituitary axis irradiation dose thresholds for the development of hypopituitarism in adult‐onset gliomas

Kyriakakis

Lynch

Orme

et al. 2019

Clinical Endocrinology

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Background: Childhood brain tumour survivors who receive cranial radiotherapy undergo regular surveillance for the development ofhypothalamic-pituitary (HP) axis dysfunction. Much less attention has been given to radiation-induced hypopituitarism in patients with malignant brain tumours of adult onset.Design: Retrospective cohort study. Patients/Measurements:We assessed the effects of cranial radiotherapy (cXRT) on pituitary function in 58 adults (32 male) with gliomas distant to the HP axis. The XRT dose exposure at the HP axis was correlated with individual axis dysfunction to establish dose thresholds.Results: Mean age at cXRT was 41.2 ± 10.9 years and duration of endocrine followup 8.2 ± 5.2 years. Mean XRT dose to the HP axis was 35.9 ± 15.5 Gy. Overall prevalence of radiation-induced hypopituitarism was 84.5%. GH, LH/FSH, ACTH and TSH deficiency were present in 82.8%, 20.7%, 19% and 6.9% of patients, respectively. Hyperprolactinaemia was noted in 10.3% (n = 6) and was persistent in one case. GH deficiency and "any degree of hypopituitarism" positively correlated with the radiotherapy dose to the hypothalamic-pituitary axis. HP axis XRT dose thresholds for the development of GHD, LH/FSH, ACTH and TSH deficiency were established at 10, 30, 32 and 40.8 Gy, respectively. A gradual increase in the prevalence of all anterior pituitary hormone deficits was observed throughout the follow-up period. Conclusions:Hypopituitarism post-cXRT in adults with gliomas is a frequent, progressive and dose-dependent phenomenon. Dose thresholds suggest long-term endocrine surveillance is important where the HP axis XRT dose is higher than 30 Gy. Identification of deficits to allow early and appropriate hormone replacement therapy is important to improve well-being in these individuals with limited prognosis. K E Y W O R D Sadult-onset gliomas, cranial radiotherapy, growth hormone deficiency, hypopituitarism 132 | KYRIAKAKIS et Al.

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Section: Discussionmentioning

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Hypothalamic‐pituitary axis irradiation dose thresholds for the development of hypopituitarism in adult‐onset gliomas

Kyriakakis

Lynch

Orme

et al. 2019

Clinical Endocrinology

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“…There were 135 potentially eligible studies, of which 63 were included in this review after full eligibility assessment (Fig. 1 ) 9 – 37 . One study reported two distinct populations 14 .…”

Section: Resultsmentioning

confidence: 99%

Longer-term (≥ 2 years) survival in patients with glioblastoma in population-based studies pre- and post-2005: a systematic review and meta-analysis

Poon

Sudlow

Figueroa

et al. 2020

Sci Rep

196

128

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Translation of survival benefits observed in glioblastoma clinical trials to populations and to longerterm survival remains uncertain. We aimed to assess if ≥ 2-year survival has changed in relation to the trial of radiotherapy plus concomitant and adjuvant temozolomide published in 2005. We searched MEDLINE and Embase for population-based studies with ≥ 50 patients published after 2002 reporting survival at ≥ 2 years following glioblastoma diagnosis. Primary endpoints were survival at 2-, 3-and 5-years stratified by recruitment period. We meta-analysed survival estimates using a random effects model stratified according to whether recruitment ended before 2005 (earlier) or started during or after 2005 (later). PROSPERO registration number CRD42019130035. Twentythree populations from 63 potentially eligible studies contributed to the meta-analyses. Pooled 2-year overall survival estimates for the earlier and later study periods were 9% (95% confidence interval [CI] 6-12%; n/N = 1,488/17,507) and 18% (95% CI 14-22%; n/N = 5,670/32,390), respectively. Similarly, pooled 3-year survival estimates increased from 4% (95% CI 2-6%; n/N = 325/10,556) to 11% (95% CI 9-14%; n/N = 1900/16,397). One study with a within-population comparison showed similar improvement in survival among the older population. Pooled 5-year survival estimates were 3% (95% CI 1-5%; n/N = 401/14,919) and 4% (95% CI 2-5%; n/N = 1,291/28,748) for the earlier and later periods, respectively. Meta-analyses of real-world data suggested a doubling of 2-and 3-year survival in glioblastoma patients since 2005. However, 5-year survival remains poor with no apparent improvement. Detailed clinically annotated population-based data and further molecular characterization of longer-term survivors may explain the unchanged survival beyond 5 years. Glioblastoma multiforme is the most common primary malignant brain tumour in adults with an incidence rate of 3.7 per 100,000 person-years, though geographical variation exists 1. Despite an increasing understanding of the underlying pathophysiology, glioblastoma remains an incurable disease with high mortality 2. A landmark clinical trial in 2005 demonstrated that the addition of concomitant and adjuvant temozolomide to radiotherapy provided an additional survival benefit to patients diagnosed with glioblastoma 3. Multiple clinical trials had investigated novel therapies that showed promise in pre-clinical and early phase studies, but to date there have been no major additions to the treatment armamentarium for newly diagnosed patients since 2005. The median survival in the intervention arm of the 2005 trial was 14.6 months 3 , but there is uncertainty about whether survival benefit from clinical trials is translated to the population 4,5. Clinical trial participation itself is associated with better survival 6 , which may be caused by the preferential inclusion and exclusion criteria into clinical trials. In clinical practice not all patients are eligible for the trial standard of care involving maximal surgical debul...

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“…More than 1.7 million new cancer cases and over 600,000 cancer deaths are estimated in 2019 in the United States alone (Siegel et al, 2019). Brain cancer is one of the deadliest cancer types with low survival rates among both women and men (Siegel et al, 2016;Yuan et al, 2016). Cancer research relies on accurate and reproducible disease characterizations in order to better understand what triggers cancer and how cancer progresses so that more effective means of evaluating cancer interventions can be developed.…”

Section: Introductionmentioning

confidence: 99%

Segmentation and Classification in Digital Pathology for Glioma Research: Challenges and Deep Learning Approaches

et al. 2020

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Canadian brain cancer survival rates by tumour type and region: 1992–2008

Cited by 16 publications

References 16 publications

Hypothalamic‐pituitary axis irradiation dose thresholds for the development of hypopituitarism in adult‐onset gliomas

Hypothalamic‐pituitary axis irradiation dose thresholds for the development of hypopituitarism in adult‐onset gliomas

Longer-term (≥ 2 years) survival in patients with glioblastoma in population-based studies pre- and post-2005: a systematic review and meta-analysis

Segmentation and Classification in Digital Pathology for Glioma Research: Challenges and Deep Learning Approaches

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