Therapeutic approach in glioblastoma multiforme with primitive neuroectodermal tumor components: case report and review of the literature
| Autor: | Annamaria Di Palma, Silvia Pecorari, Federico Caporlingua, Giovanni Caffarena, Sara Elena Rebuzzi, Maurizio Salvati, Vincenzo Bianco, Arsela Prelaj, Carmela Fusto, Alessandro Caporlingua, Julio Rodrigo Giròn Berrìos, Silverio Tomao, Fabio Massimo Magliocca |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Oncology
Cancer Research medicine.medical_specialty medicine.medical_treatment urologic and male genital diseases 03 medical and health sciences glioblastoma multiforme 0302 clinical medicine Glioma Internal medicine medicine primitive neuroectodermal tumor platinum-based chemotherapy craniospinal irradiation treatment Chemotherapy Temozolomide urogenital system business.industry Cancer Multimodal therapy Articles medicine.disease female genital diseases and pregnancy complications nervous system diseases 030220 oncology & carcinogenesis Primitive neuroectodermal tumor Concomitant business 030217 neurology & neurosurgery Chemoradiotherapy medicine.drug |
| Popis: | Glioblastoma multiforme (GBM) is the most common and aggressive malignant glioma that is treated with first-line therapy, using surgical resection followed by local radiotherapy and concomitant/adjuvant temozolomide (TMZ) treatment. GBM is characterised by a high local recurrence rate and a low response to therapy. Primitive neuroectodermal tumour (PNET) of the brain revealed a low local recurrence rate; however, it also exhibited a high risk of cerebrospinal fluid (CSF) dissemination. PNET is treated with surgery followed by craniospinal irradiation (CSI) and platinum-based chemotherapy in order to prevent CSF dissemination. GBM with PNET-like components (GBM/PNET) is an emerging variant of GBM, characterised by a PNET-like clinical behaviour with an increased risk of CSF dissemination; it also may benefit from platinum-based chemotherapy upfront or following failure of GBM therapy. The results presented regarding the management of GBM/PNET are based on case reports or case series, so a standard therapeutic approach for GBM/PNET is not defined, constituing a challenging diagnostic and therapeutic dilemma. In this report, a case of a recurrent GBM/PNET treated with surgical resection and radiochemotherapy as Stupp protocol, and successive platinum-based chemotherapy due to the development of leptomeningeal dissemintation and an extracranial metastasis, is discussed. A review of the main papers regarding this rare GBM variant and its therapeutic approach are also reported. In conclusion, GBM/PNET should be treated with a multimodal approach including surgery, chemoradiotherapy, and/or the early introduction of CSI and platinum-based chemotherapy upfront or at recurrence. |
| Databáze: | OpenAIRE |
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