Long-Term Outcome of Postoperative Irradiation in Patients with Newly Diagnosed WHO Grade III Anaplastic Gliomas

Nagy, Mónika; Schulz-Ertner, Daniela; Bischof, Marc; Welzel, Thomas; Hof, Holger; Debus, Jürgen; Combs, Stephanie E.

doi:10.1177/030089160909500308

Cited by 11 publications

(10 citation statements)

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“…21,23,24,30,31 Nomiya et al 21 analyzed survival outcomes and prognostic factors for 170 patients with AA and found that patients who underwent total or subtotal resection had a significantly more favorable prognosis than did patients who underwent partial resection or biopsy. Two other studies reported incremental improvements in overall median survival with increased extent of surgical resection among patients with histologically different anaplastic gliomas (pure AA vs anaplastic oligoastrocytoma vs AO).…”

Section: Extent Of Surgical Resectionmentioning

confidence: 99%

“…Two other studies reported incremental improvements in overall median survival with increased extent of surgical resection among patients with histologically different anaplastic gliomas (pure AA vs anaplastic oligoastrocytoma vs AO). 23,30 Nagy et al 30 reported a median OS of 32 months after GTR, 36 months after subtotal resection, and 12 months after biopsy.…”

Section: Extent Of Surgical Resectionmentioning

confidence: 99%

“…27,28,30,34 Some studies have shown a moderately favorable median OS for patients with AA (7 months, inclusive of biopsies and partial resections) and AO (47 months, inclusive of biopsies and partial resections) after postoperative RT, 30 whereas others seem to suggest that AO tumors harboring the 1p/19q deletion may be exclusively treated with chemotherapy. 34 Although the Iwadate et al 34 cohort of 25 AO patients showed longer progression-free survival among 1p/19q codeletion patients and a 62.2% 5-year OS rate for all patients, this study had a median follow-up period of 3 years and fails to provides definite evidence for the role of chemotherapy as exclusive treatment for AO patients.…”

Section: Impact Of Rtmentioning

confidence: 99%

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Survival and Prognostic Factors of Anaplastic Gliomas

et al. 2013

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Section: Extent Of Surgical Resectionmentioning

confidence: 99%

Section: Extent Of Surgical Resectionmentioning

confidence: 99%

Section: Impact Of Rtmentioning

confidence: 99%

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Survival and Prognostic Factors of Anaplastic Gliomas

et al. 2013

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“…MIF expression in human glioblastomas is also correlated with vascular endothelial growth factor (VEGF) expression [16]. In the clinical setting, the histological grading is a key factor for predicting the biological behavior of gliomas and influencing the choice of therapies, particularly determining the use of adjuvant radiation and specific chemotherapy protocols [17,18]. However, to our knowledge, the exact relationship between histological grading and MIF expression in tumor cells has not yet been elucidated in sufficient detail.…”

Section: Introductionmentioning

confidence: 99%

Elevated expression of macrophage migration inhibitory factor correlates with tumor recurrence and poor prognosis of patients with gliomas

Wang

Tian

et al. 2011

J Neurooncol

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Macrophage migration inhibitory factor (MIF) plays a critical role in tumorigenesis. We aim to examine the association of MIF with tumor recurrence and survival of gliomas, and to determine whether MIF is a valuable prognostic predictor for glioma patients. The expression of MIF and interleukin 8 (IL-8) was evaluated in 36 high-grade gliomas (20 glioblastoma multiforme, 13 anaplastic astrocytoma, and 3 anaplastic oligoastrocytoma) and 32 low-grade gliomas (18 fibrillary astrocytoma, 5 pilocytic astrocytoma, 5 oligodendroglioma, 3 ependymoma and 1 pleomorphic xanthoastrocytoma) by immunostaining. Intratumoral microvessel density (IMD) of tumors in relation to immunostainings and clinicopathological factors were analyzed statistically as well as the follow-up data of patients. High expression of both MIF (58.8%) and IL-8 (52.9%) was significantly associated with high-grade gliomas and increased microvessels in tumors, but only high expression of MIF was closely related to tumor recurrence (P = 0.001). High expression of IL-8 exhibited a close correlation with high expression of MIF in tumors (P = 0.001). Histological grading, high expression of MIF and IL-8 correlated with patients' overall survival in univariate analysis. However, only histological grading and MIF expression exhibited a relationship with survival of patients as independent prognostic factors of glioma by multivariate analysis; the hazard ratios were 28.012 (P = 0.001) and 11.782 (P = 0.001), respectively. Elevated production of MIF in glioma tumor cells may contribute to tumor recurrence and a worse prognosis. MIF may serve as an independent predictive factor for prognosis of glioma patients.

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“…For anaplastic gliomas, overall survival after standard treatment following primary diagnosis, including neurosurgical resection and postoperative radiotherapy, lies between 18 and 50 months [3]. However, also these patients develop tumor recurrences after primary diagnosis, and effective salvage treatments are required.…”

Section: Introductionmentioning

confidence: 99%

Randomised phase I/II study to evaluate carbon ion radiotherapy versus fractionated stereotactic radiotherapy in patients with recurrent or progressive gliomas: The CINDERELLA trial

et al. 2010

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BackgroundTreatment of patients with recurrent glioma includes neurosurgical resection, chemotherapy, or radiation therapy. In most cases, a full course of radiotherapy has been applied after primary diagnosis, therefore application of re-irradiation has to be applied cauteously. With modern precision photon techniques such as fractionated stereotactic radiotherapy (FSRT), a second course of radiotherapy is safe and effective and leads to survival times of 22, 16 and 8 months for recurrent WHO grade II, III and IV gliomas.Carbon ions offer physical and biological characteristics. Due to their inverted dose profile and the high local dose deposition within the Bragg peak precise dose application and sparing of normal tissue is possible. Moreover, in comparison to photons, carbon ions offer an increased relative biological effectiveness (RBE), which can be calculated between 2 and 5 depending on the GBM cell line as well as the endpoint analyzed. Protons, however, offer an RBE which is comparable to photons.First Japanese Data on the evaluation of carbon ion radiation therapy for the treatment of primary high-grade gliomas showed promising results in a small and heterogeneous patient collective.Methods DesignIn the current Phase I/II-CINDERELLA-trial re-irradiation using carbon ions will be compared to FSRT applied to the area of contrast enhancement representing high-grade tumor areas in patients with recurrent gliomas. Within the Phase I Part of the trial, the Recommended Dose (RD) of carbon ion radiotherapy will be determined in a dose escalation scheme. In the subsequent randomized Phase II part, the RD will be evaluated in the experimental arm, compared to the standard arm, FSRT with a total dose of 36 Gy in single doses of 2 Gy.Primary endpoint of the Phase I part is toxicity. Primary endpoint of the randomized part II is survival after re-irradiation at 12 months, secondary endpoint is progression-free survival.DiscussionThe Cinderella trial is the first study to evaluate carbon ion radiotherapy for recurrent gliomas, and to compare this treatment to photon FSRT in a randomized setting using an ion beam delivered by intensity modulated rasterscanning.Trial RegistrationNCT01166308

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Long-Term Outcome of Postoperative Irradiation in Patients with Newly Diagnosed WHO Grade III Anaplastic Gliomas

Abstract: Patients with WHO grade III anaplastic astrocytomas, oligodendrogliomas and oligoastrocytomas show favorable overall survival after postoperative radiotherapy compared with glioblastoma patients and should therefore be analyzed separately. Radiochemotherapy might further improve outcome.

Cited by 11 publications

References 61 publications

Survival and Prognostic Factors of Anaplastic Gliomas

Survival and Prognostic Factors of Anaplastic Gliomas

Elevated expression of macrophage migration inhibitory factor correlates with tumor recurrence and poor prognosis of patients with gliomas

Randomised phase I/II study to evaluate carbon ion radiotherapy versus fractionated stereotactic radiotherapy in patients with recurrent or progressive gliomas: The CINDERELLA trial

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