Combined modality therapy of operated astrocytomas grade III and IV. Confirmation of the value of postoperative irradiation and lack of potentiation of bleomycin on survival time: A prospective multicenter trial of the scandinavian glioblastoma study group

Kristiansen, Kristian; Hagen, Steinar; Kollevold, T; Torvik, Ansgar; Holme, IM; Stat, M; Nesbakken, R; Hatlevoll, Reidulv; Lindgren, Marie; Brun, Arne; Lindgren, S.; Notter, G; Andersen, Asser S.; Elgen, K.

doi:10.1002/1097-0142(19810215)47:4<649::aid-cncr2820470405>3.0.co;2-w

Cited by 383 publications

(128 citation statements)

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“…A key question is whether the results presented here are consistent with clinical experience and in particular the clinical outcomes in patients undergoing radiotherapy. Multiple studies have demonstrated an overall survival benefit for postoperative radiation therapy after surgical resection compared with surgery alone in the management of newly diagnosed glioblastoma multiforme (GBM) (34)(35)(36). In addition, the response of GBM tumors to radiation predicts the patient lifespan after treatment.…”

Section: Ir Induces Cytotoxic Type I Ifnmentioning

confidence: 99%

RIG-I–like receptor LGP2 protects tumor cells from ionizing radiation

Widau¹,

Parekh²,

Ranck³

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

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An siRNA screen targeting 89 IFN stimulated genes in 14 different cancer cell lines pointed to the RIG-I (retinoic acid inducible gene I)-like receptor Laboratory of Genetics and Physiology 2 (LGP2) as playing a key role in conferring tumor cell survival following cytotoxic stress induced by ionizing radiation (IR). Studies on the role of LGP2 revealed the following: (i) Depletion of LGP2 in three cancer cell lines resulted in a significant increase in cell death following IR, (ii) ectopic expression of LGP2 in cells increased resistance to IR, and (iii) IR enhanced LGP2 expression in three cell lines tested. Studies designed to define the mechanism by which LGP2 acts point to its role in regulation of IFNβ. Specifically (i) suppression of LGP2 leads to enhanced IFNβ, (ii) cytotoxic effects following IR correlated with expression of IFNβ inasmuch as inhibition of IFNβ by neutralizing antibody conferred resistance to cell death, and (iii) mouse embryonic fibroblasts from IFN receptor 1 knockout mice are radioresistant compared with wild-type mouse embryonic fibroblasts. The role of LGP2 in cancer may be inferred from cumulative data showing elevated levels of LGP2 in cancer cells are associated with more adverse clinical outcomes. Our results indicate that cytotoxic stress exemplified by IR induces IFNβ and enhances the expression of LGP2. Enhanced expression of LGP2 suppresses the IFN stimulated genes associated with cytotoxic stress by turning off the expression of IFNβ.innate immunity | cytoplasmic sensor | interferon beta | DHX58

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Section: Ir Induces Cytotoxic Type I Ifnmentioning

confidence: 99%

RIG-I–like receptor LGP2 protects tumor cells from ionizing radiation

Widau¹,

Parekh²,

Ranck³

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

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“…Median duration of survival after surgery and radiation in various series has been reported to be 24 months for anaplastic astrocytoma and 9 months for glioblastoma (Walker et al, 1978(Walker et al, , 1980Kristiansen et al, 1981;Chang et al, 1983;Green et al, 1983). Addition of chemotherapy has increased median survival to approximately 11 months for glioblastoma (Walker et al, 1978(Walker et al, , 1980Chang et al, 1983;Green et al, 1983).…”

Section: Does Surgical Resection Prolong Survival?mentioning

confidence: 99%

Management of malignant glioma: role of surgery in relation to multimodality therapy

Black

1998

J Neurovirol

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The goals of surgery for malignant glioma are to establish a histological diagnosis and to achieve mechanical cytoreduction to reduce intracranial pressure (ICP) and possibly alter tumor kinetics. There is controversy concerning the question whether the glioma is a focal or diffuse process; it appears that there may be variability between the two extremes in individual cases. The question of the value of surgery has also been controversial. Review of the literature suggests that both early and long-term postoperative outcome after radical surgical resection are better than the results of either partial resection or simple biopsy, in terms of neurological status and duration of survival. Similarly, reoperation for recurrence of glioma offers reasonable extension of quality survival. Despite the desirability of extensive cytoreductive surgery for malignant gliomas, the presence of viable in®ltrative cells beyond the margins of the resection necessitate that surgery be a part of an aggressive multimodality therapeutic approach. Adjunctive measures to control the in®ltrative component include newer forms of radiotherapy (such as stereotaxic radiosurgery) and newer delivery techniques for chemotherapy (agents impregnated in biodegradable polymers implanted in the tumor bed after surgical resection), and possibly immunotherapy and gene therapy as they may become feasible in the future. The strategy for management of malignant glioma thus consists of a combination of extensive surgical resection to reduce the accessible tumor burden, followed in rapid sequence by measures to control the in®ltrative portion of the tumor. It is recommended that these measures be offered`up front' rather than delaying treatment until there is clinical or radiographic evidence of tumor recurrence.

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“…With modern treatment paradigms the median survival time of patients with the most malignant glioma, glioblastoma multiforme (GBM), has increased from several months to over a year in selected series (Walker et al, 1978;Kristiansen et al, 1981;Gutin et al, 1991). Survival in patients with other intracranial primary neoplasms and metastatic disease has likewise increased.…”

Section: Introductionmentioning

confidence: 99%