|Table of Contents|

Effect analysis of operation of high grade glioma combining with postoperative radiotherapy and chemotherapy (56 cases)

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 10
Page:
1838-1843
Research Field:
Publishing date:

Info

Title:
Effect analysis of operation of high grade glioma combining with postoperative radiotherapy and chemotherapy (56 cases)
Author(s):
HUI Hongyan1; ZHOU Xiang2; YANG Jun3; WANG Zhongwei2; JIN Baozhe2
1.Pharmacy Department;2.Neurosurgery Ward;3.Radiotherapy Department,the First Affiliated Hospital of Xinxiang Medical University,Henan Weihui 453100,China.
Keywords:
high grade glioma; operation; radiotherapy and chemotherapy; curative effect
PACS:
R730.264
DOI:
10.3969/j.issn.1672-4992.2023.10.012
Abstract:
Objective:To explore the effect of operation and postoperative radiotherapy and chemotherapy for high grade glioma.Methods:The clinical data of 56 patients with high grade gliomas were analyzed retrospectively.All patients were treated with operation,postoperative concurrent radiotherapy and more than 6 cycles of Temozolomide chemotherapy.Results:Total resection was performed in 10 cases (17.9%),subtotal resection in 35 cases (62.5%) and partial resection in 11 cases (19.6%).Molecular pathology showed IDH1132H mutation in 19 cases and MGMT gene promoter methylation in 20 cases.During the follow-up,there were 13 cases without obvious relapse,35 cases with recurrence,1 case with multiple metastasis of spinal cord,7 cases with radiation brain injury,3 cases with reoperation decompression and 4 cases with conservative treatment.The overall survival rates of 12 months,24 months and 36 months were 66.1%,50.0% and 32.1%,and the progression free survival rates were 57.1%,39.3% and 25.0%.Conclusion:The prognosis of high-grade gliomas is poor,and postoperative residual,recurrence,metastasis and radiation injury are the key and difficult points of treatment.The overall survival rate and progression free survival rate of patients with MGMT promoter methylation were higher than those of patients with MGMT promoter unmethylation.

References:

［1］LOUIS DN,PERRY A,WESSELING P,et al.The 2021 WHO classification of tumors of the central nervous system:a summary［J］.Neuro Oncol,2021,23(8):1231-1251.
［2］杨学军,江涛.脑胶质瘤的临床诊治撷要［J］.中华神经医学杂志,2020,19(12):1189-1193. YANG XJ,JIANG T.Clinical diagnosis and treatment of glioma［J］.Chinese Journal of Neuromedicine,2020,19(12):1189-1193.
［3］PELLERINO A,FRANCHIONO F,SOFFIETTI R,et al.Overview on current treatment standards in high-grade gliomas［J］.Quarterly Journal of Nuclear Medicine and Molecular Imaging,2018,62(3):225-238.
［4］JIANG T,NAM DH,RAM Z,et al.Clinical practice guidelines for the management of adult diffuse gliomas［J］.Cancer Lett,2021,499:60-72.
［5］BLOCH O,HAN SJ,CHA S,et al.Impact of extent of resection for recurrent glioblastoma on overall survival:clinical article［J］.J Neurosurg,2012,117(6):1032-1038.
［6］ESEONU CI,REFAEY K,GARCIA O,et al.Volumetric analysis of extent of resection,survival,and surgical outcomes for insular gliomas［J］.World Neurosurgery,2017,103:265-274.
［7］CHAICHANA KL,JUSUE-TORRES I,NAVARRO-RAMIREZ,et al.Establishing percent resection and residual volume Thresholds affecting survival and recurrence for patients with newly diagnosed intracranial glioblastoma［J］.Neuro-oncology,2014,16(1):113-122.
［8］WALKER MD，GREE SB，BYAR DP，et al.Randomized comparisons of radiotherapy and nitrosotreas for the treatment of malignant glioma after surgery［J］.N Engl J Med,1979,303:1323-1731．
［9］CONNOR M,KIM MM,CAO Y.Precision radiotherapy for gliomas:Implementing novel imaging biomarkers to improve outcomes with patient-specific therapy［J］.The Cancer Journal,2021,27(5):353-363.
［10］HERMANTO U,FRIJA EK,LII MJ,et al.Intensity-modulated radiotherapy(IMRT) and conventional three-dimensional conformal radiotherapy for high grade gliomas:does IMRT increase the integral dose to normal brain［J］.Int J Radiat Oncol Biol Phys,2007,67:1135-1144．
［11］MINNITI G,NIYAZI M,ALONGI F,et al.Current status and recent advances in reirradiation of glioblastoma［J］.Radiation Oncology,2021,16(1):36.
［12］ WONG CS,VAN D,KOGEL AJ.Mechanisms of radiation injury to the central nervous system:implications for neuroprotection［J］.Mol Interv,2004,4(5):273-284.
［13］ YOSHII Y.Pathological review of late cerebral radionecrosis［J］.Brain Tumor Pathol,2008,25(2):51-58.
［14］BAPURAJ,JAYAPALLI R,WANG,et al.Advanced imaging and computational techniques for the diagnostic and prognostic assessment of malignant gliomas［J］.The Cancer Journal,2021,27(5):344-352.
［15］中国放射性脑损伤多学科协作组,中国医师协会神经内科分会脑与脊髓损害专业委员会.放射性脑损伤诊治中国专家共识［J］.中华神经医学杂志,2019,18(6):541-549. Chinese Multidisciplinary Collaboration Group of Radiation-induced Brain Injury,Specialized Committee Professional Board of Brain and Spinal Cord Injury,Neurology Branch of Chinese Medical Doctor Association.Diagnoses and treatments of radiation-induced brain injury:an expert consensus［J］.Chinese Journal of Neuromedicine,2019,18(6):541-549.
［16］ PARK YW,CHOI D,PARK JE,et al.Differentiation of recurrent glioblastoma from radiation necrosis using diffusion radiomics with machine learning model development and external validation［J］.Scientific Reports,2021,11(1):2913.
［17］王孝深，胡超苏.放射性脑坏死的新认识与防治［J］.中华放射肿瘤学杂志，2016,25(9):911-916. WANG XS,HU CS.Research advances in prevention and treatment of cerebral radiation necrosis［J］.Chin J Radiat Onco,2016,25(9):911-916.
［18］VOSS M,WENGER KJ,FOKAS E,et al.Single-shot bevacizumab for cerebral radiation injury［J］.BMC Neurology,2021,21(1):77.
［19］朱国华,麦麦提力·米吉提,李彦东,等.高级别胶质瘤的预后影响因素分析［J］.临床神经外科杂志,2019,16(5):430-433,438. ZHU GH,MAIMAITILI·MJT,LI YD,et al.Analysis of factors related to prognosis in patients with high-grade glioma［J］.J ClinNeurosurg,2019,16(5):430-433,438.
［20］卫力文,姚冰,孙佩欣,等.63例高级别胶质瘤中IDH1和TERT突变状态的预后价值［J］.现代肿瘤医学,2020,28(14):2412-2416. WEI LW,YAO B,SUN PX,et al.Prognostic significance of IDH1 and TERT promotor mutations in 63 patients with high-grade gliomas［J］.Modern Oncology,2020,28(14):2412-2416.
［21］中国脑胶质瘤协作组,中国脑胶质瘤基因组图谱计划.中国脑胶质瘤分子诊疗指南［J］.中华神经外科杂志,2014,30(5):435-444. CGCG,CGGA.Guidelines for molecular diagnosis and treatment of glioma in China［J］.Chin J Neurosurg,2014,30(5):435-444.
［22］吴静,陈绪珠,马强,等.分子标志物在高级别胶质瘤患者预后评估中的价值［J］.现代肿瘤医学,2021,29(24):4309-4311. WU J,CHEN XZ,MA Q,et al.The prognostic value of molecular markers in patients with high-grade glioma［J］.Modern Oncology,2021,29(24):4309-4311.
［23］《中国中枢神经系统胶质瘤诊断和治疗指南》编写组.中国中枢神经系统胶质瘤诊断和治疗指南［J］.中华医学杂志,2016,96(7):485-510. Compilation group of Chinese guidelines for diagnosis and treatment of central nervous system gliomas.Chinese guidelines for diagnosis and treatment of central nervous system gliomas［J］.Natl Med J China,2016,96(7):485-510.
［24］LOUIS DN,PERRY A,REIFENBERGER G,et al.The 2016 World Health Organization classification of tumors of the central nervous system:a summary［J］.Acta Neuropathol,2016,131(6):803-820．
［25］HSU BH,LEE WH,YANG ST,et al.Spinal metastasis of glioblastomamultiforme before gliosarcomatoustransformation:a case report［J］.BMC Neurol,2020,20:178.
［26］LI Z,CHENG YF,SHAO ZY,et al.Multiple extracranial metastases from secondary glioblastomamultiforme:a case report and review of the literatue［J］.J Neurooncol,2010,97(3):451-457.
［27］SAGBERG LM,JAKOLA AS,REINERTSEN I,et al.How well do neurosurgeons predict survival in patients with high-grade glioma［J］.Neurosurgical Review,2022,45(1):865-872.

Memo

Memo:
吴阶平医学基金会临床科研专项资助基金（编号：320675010071）
Last Update: 1900-01-01