Radiotherapy-induced glioblastoma: distinct differences in overall survival, tumor location, pMGMT methylation and primary tumor epidemiology in Hong Kong chinese patients.

Autor:	Woo PYM; Department of Neurosurgery, Kwong Wah Hospital, Hong Kong, Hong Kong., Lee JWY; Department of Neurosurgery, Kwong Wah Hospital, Hong Kong, Hong Kong., Lam SW; Department of Neurosurgery, Kwong Wah Hospital, Hong Kong, Hong Kong., Pu JKS; Division of Neurosurgery, Department of Surgery, Queen Mary Hospital, Hong Kong, Hong Kong., Chan DTM; Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong., Mak CHK; Department of Neurosurgery, Queen Elizabeth Hospital, Hong Kong, Hong Kong., Ho JMK; Department of Neurosurgery, Tuen Mun Hospital, Hong Kong, Hong Kong., Wong ST; Department of Neurosurgery, Tuen Mun Hospital, Hong Kong, Hong Kong., Po YC; Department of Neurosurgery, Princess Margaret Hospital, Hong Kong, Hong Kong., Lee MWY; Department of Neurosurgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Hong Kong., Chan KY; Department of Neurosurgery, Kwong Wah Hospital, Hong Kong, Hong Kong., Poon WS; Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong.
Jazyk:	angličtina
Zdroj:	British journal of neurosurgery [Br J Neurosurg] 2024 Apr; Vol. 38 (2), pp. 385-392. Date of Electronic Publication: 2021 Feb 12.
DOI:	10.1080/02688697.2021.1881445
Abstrakt:	Introduction: Radiotherapy-induced glioblastomas (RIGB) are a well-known late and rare complication of brain irradiation. Yet the clinical, radiological and molecular characteristics of these tumors are not well characterized. Methods: This was a retrospective multicentre study that analysed adult patients with newly diagnosed glioblastoma over a 10-year period. Patients with RIGB were identified according to Cahan's criteria for radiation-induced tumors. A case-control analysis was performed to compare known prognostic factors for overall survival (OS) with an independent cohort of IDH-1 wildtype de novo glioblastomas treated with standard temozolomide chemoradiotherapy. Survival analysis was performed by Cox proportional hazards regression. Results: A total of 590 adult patients were diagnosed with glioblastoma. 19 patients (3%) had RIGB. The mean age of patients upon diagnosis was 48 years ± 15. The mean latency duration from radiotherapy to RIGB was 14 years ± 8. The mean total dose was 58Gy ± 10. One-third of patients (37%, 7/19) had nasopharyngeal cancer and a fifth (21%, 4/19) had primary intracranial germinoma. Compared to a cohort of 146 de novo glioblastoma patients, RIGB patients had a shorter median OS of 4.8 months versus 19.2 months ( p -value: <.001). Over a third of RIGBs involved the cerebellum (37%, 7/19) and was higher than the control group (4%, 6/146; p -value: <.001). A fifth of RIGBs (21%, 3/19) were p MGMT methylated which was significantly fewer than the control group (49%, 71/146; p -value: .01). For RIGB patients (32%, 6/19) treated with re-irradiation, the one-year survival rate was 67% and only 8% for those without such treatment ( p -value: .007). Conclusion: The propensity for RIGBs to develop in the cerebellum and to be p MGMT unmethylated may contribute to their poorer prognosis. When possible re-irradiation may offer a survival benefit. Nasopharyngeal cancer and germinomas accounted for the majority of original malignancies reflecting their prevalence among Southern Chinese.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu