Malignant Transformation of Molecularly Classified Adult Low-Grade Glioma
| Autor: | Martin C. Tom, Wei Wei, David M. Peereboom, Xuefei Jia, Vamsi Varra, Manmeet S Ahluwalia, Ehsan H. Balagamwala, Michael A. Vogelbaum, Erin S. Murphy, Glen Stevens, Kailin Yang, Richard A. Prayson, Deborah Y. Park, G.H. Barnett, C. Marc Leyrer, John H. Suh, Samuel T. Chao, Jennifer S. Yu |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Oncology Cancer Research medicine.medical_specialty medicine.medical_treatment 030218 nuclear medicine & medical imaging Malignant transformation 03 medical and health sciences Sex Factors 0302 clinical medicine Internal medicine Glioma Temozolomide medicine Humans Radiology Nuclear Medicine and imaging Risk factor Watchful Waiting Antineoplastic Agents Alkylating Aged Chemotherapy Radiation Brain Neoplasms business.industry Incidence (epidemiology) Chemoradiotherapy Middle Aged medicine.disease Isocitrate Dehydrogenase Tumor Burden Radiation therapy Cell Transformation Neoplastic Chemotherapy Adjuvant 030220 oncology & carcinogenesis Mutation Female business Watchful waiting medicine.drug |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 105:1106-1112 |
| ISSN: | 0360-3016 |
| Popis: | Purpose Malignant transformation (MT) of adult grade 2 glioma (low-grade glioma [LGG]) is associated with adverse survival. We sought to describe the incidence, outcomes, and risk factors for MT of molecularly classified LGG. Methods and Materials We reviewed a single-institutional database of adults who received a diagnosis of LGG with data allowing for molecular classification from 1980 to 2018 to evaluate time to MT and its associated risk factors. MT was defined as pathologic confirmation of grade 3-4 glioma and/or imaging characteristics consistent with MT by multidisciplinary consensus. Results Among the included 486 adults with molecularly classified LGG, median age was 39 years (range, 18-78), median tumor size was 3.9 cm (range, 0.3-13.0), and 262 (54%) were male. Molecular classification was IDHmut1p/19qcodel in 169 (35%), IDHmut1p/19qintact in 125 (26%), and IDHwt in 192 (40%) patients. Adjuvant management was observation in 246 (51%) patients, temozolomide alone in 82 (16%), radiation therapy alone in 63 (13%), and radiation therapy concurrent with temozolomide in 81 (17%). Temozolomide monotherapy was more likely to be given to IDHmut1p/19qcodel patients (P Conclusions MT of LGG has a poor prognosis associated with unfavorable molecular groups. Analysis of our large cohort identified adjuvant temozolomide monotherapy as the only modifiable risk factor for MT and provides the first clinical evidence of temozolomide-associated MT among molecularly classified adult LGG. This novel finding supplements our understanding of temozolomide-induced hypermutation and informs precision management of LGG. |
| Databáze: | OpenAIRE |
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