Pub Date : 2021-01-01DOI: 10.4103/glioma.glioma_31_20
H. Tan, S. Low, C. Tan
Intratumoral metastasis is rare, and in the brain, meningiomas are the most common type of primary brain tumors to harbor metastases. We report a case of angiomatous microcystic meningioma associated with intratumoral metastatic lung adenocarcinoma in a patient with no prior history of malignancy, in which the pronounced atypia of the meningioma potentially mimics or masks the minute focus of metastatic cancer. A meticulous search for intratumoral metastasis within the meningioma is recommended if metastasis is clinically suspected. A formal ethical approval for the single case report is waived by the Institutional Review Board of National University Health System, Singapore.
{"title":"A case report of atypia in angiomatous microcystic meningioma: A mimicker and masker of intratumoral metastasis in a patient with no known systemic malignancy","authors":"H. Tan, S. Low, C. Tan","doi":"10.4103/glioma.glioma_31_20","DOIUrl":"https://doi.org/10.4103/glioma.glioma_31_20","url":null,"abstract":"Intratumoral metastasis is rare, and in the brain, meningiomas are the most common type of primary brain tumors to harbor metastases. We report a case of angiomatous microcystic meningioma associated with intratumoral metastatic lung adenocarcinoma in a patient with no prior history of malignancy, in which the pronounced atypia of the meningioma potentially mimics or masks the minute focus of metastatic cancer. A meticulous search for intratumoral metastasis within the meningioma is recommended if metastasis is clinically suspected. A formal ethical approval for the single case report is waived by the Institutional Review Board of National University Health System, Singapore.","PeriodicalId":12731,"journal":{"name":"Glioma","volume":"4 1","pages":"12 - 14"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42429323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.4103/glioma.glioma_1_21
Y. Diansari, Norman Djamaluddin, Ashita Hulwah
Temozolomide is an orally administered chemotherapeutic drug that has become a standard treatment for malignant gliomas. Severe toxicity of temozolomide is rare, especially shortly after administration. We report a 37-year-old male patient diagnosed with anaplastic astrocytoma following tumor resection. He was treated postoperatively with cranial radiation and adjuvant temozolomide 150 mg/m2 for six planned cycles. However, 3 days after finishing the first cycle of temozolomide, the patient's condition deteriorated. Laboratory results showed thrombocytopenia and lymphopenia, and chest X-ray revealed an infiltrate in the right segment of the lung, suggesting pneumonia. These conditions were thought to be caused by temozolomide. Although temozolomide is generally well tolerated by glioma patients, several adverse effects have been reported. In addition, malignancy, corticosteroids, and chemotherapy are known to increase the risk of immunosuppression. Close monitoring of patients treated with temozolomide is warranted, especially brain tumor patients, due to the risk of myelosuppression and severe infection. The work was approved by the Health Research Ethics Committee of DR Mohammad Hoesin Hospital (No. 130/kepkrsmh/2020) on December 15, 2020.
{"title":"Acute toxicity of temozolomide for the treatment of anaplastic astrocytoma: A case report","authors":"Y. Diansari, Norman Djamaluddin, Ashita Hulwah","doi":"10.4103/glioma.glioma_1_21","DOIUrl":"https://doi.org/10.4103/glioma.glioma_1_21","url":null,"abstract":"Temozolomide is an orally administered chemotherapeutic drug that has become a standard treatment for malignant gliomas. Severe toxicity of temozolomide is rare, especially shortly after administration. We report a 37-year-old male patient diagnosed with anaplastic astrocytoma following tumor resection. He was treated postoperatively with cranial radiation and adjuvant temozolomide 150 mg/m2 for six planned cycles. However, 3 days after finishing the first cycle of temozolomide, the patient's condition deteriorated. Laboratory results showed thrombocytopenia and lymphopenia, and chest X-ray revealed an infiltrate in the right segment of the lung, suggesting pneumonia. These conditions were thought to be caused by temozolomide. Although temozolomide is generally well tolerated by glioma patients, several adverse effects have been reported. In addition, malignancy, corticosteroids, and chemotherapy are known to increase the risk of immunosuppression. Close monitoring of patients treated with temozolomide is warranted, especially brain tumor patients, due to the risk of myelosuppression and severe infection. The work was approved by the Health Research Ethics Committee of DR Mohammad Hoesin Hospital (No. 130/kepkrsmh/2020) on December 15, 2020.","PeriodicalId":12731,"journal":{"name":"Glioma","volume":"4 1","pages":"15 - 18"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42025325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.4103/glioma.glioma_3_21
M. Weller, E. Rhun, P. Roth, M. Preusser
{"title":"Neuro-oncology during the COVID-19 pandemic","authors":"M. Weller, E. Rhun, P. Roth, M. Preusser","doi":"10.4103/glioma.glioma_3_21","DOIUrl":"https://doi.org/10.4103/glioma.glioma_3_21","url":null,"abstract":"","PeriodicalId":12731,"journal":{"name":"Glioma","volume":"4 1","pages":"1 - 1"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49010512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.4103/glioma.glioma_2_21
Zhongping Chen
{"title":"Perspective on the current treatment strategies for glioma","authors":"Zhongping Chen","doi":"10.4103/glioma.glioma_2_21","DOIUrl":"https://doi.org/10.4103/glioma.glioma_2_21","url":null,"abstract":"","PeriodicalId":12731,"journal":{"name":"Glioma","volume":"4 1","pages":"2 - 4"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70735365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.4103/glioma.glioma_27_20
Fugang Yang, Cheng-shi Xu, Chao Ma, Yu-hang Zhao, Zhiqiang Li
Background and Aim: Many studies have demonstrated the value of neuronavigation guided by fluorescence staining for treating glioma patients. Here, we compared the rate of overall survival (OS) and the extent of tumor resection among patients who underwent surgery with neuronavigation and fluorescence versus conventional techniques. Materials and Methods: In this case-control observational study, data from 162 patients with supratentorial glioma who underwent surgery from January 2016 to November 2017 were retrospectively analyzed, including a neuronavigation and fluorescence treatment group (combined group, n = 53) and a conventional microsurgery group (control group, n = 109). The extent of tumor resection, World Health Organization (WHO) pathological grade, eloquent areas involved, tumor diameter, preoperative Karnofsky Performance Status score, underlying diseases, chemotherapy, hospitalization days, length of operation, intraoperative blood loss, and postoperative molecular pathological indictors were recorded. OS rates were compared using the Cox proportional hazards regression model. The study was approved by the Ethics Committee of Zhongnan Hospital of Wuhan University (approval No. 2019048). Results: The total resection rate was 60.4% in the combined group and 27.5% in the control group. Multivariate logistic regression analysis revealed that involvement of eloquent areas (odds ratio [OR] = 0.455, 95% confidence interval [CI]: 0.214–0.966, P = 0.040) and the use of the combined technique (OR = 3.634, 95% CI: 1.758–7.510, P < 0.001) were independent prognostic factors affecting total glioma resection. Eloquent areas were implicated in 79 patients. Multiple logistic regression analysis revealed that the combined technique (OR = 6.041, 95% CI: 1.705–21.403, P = 0.005) was an independent prognostic factor affecting total resection. The average follow-up period was 16.4 months. Cox regression analysis revealed that the WHO tumor grade (hazard ratio [HR] = 4.782, 95% CI: 1.620-14.119, P = 0.005), chemotherapy regimen (HR = 0.324, 95% CI: 0.181–0.579, P < 0.001), IDH mutation (HR = 0.366, 95% CI: 0.154–0.870, P = 0.023), and total resection (HR = 0.458, 95% CI: 0.248–0.846, P = 0.013) were independent factors affecting the prognosis of glioma patients. Conclusions: The use of neuronavigation with fluorescent staining appears to improve the tumor resection range and the OS rate, which is an independent factor affecting the degree of resection of supratentorial glioma. The WHO tumor grade, chemotherapy regimen, IDH mutation, and total resection were independent factors affecting the prognosis of glioma patients.
{"title":"Clinical value of neuronavigation combined with a fluorescent staining technique during microsurgery for treating supratentorial glioma: A case-control observational study","authors":"Fugang Yang, Cheng-shi Xu, Chao Ma, Yu-hang Zhao, Zhiqiang Li","doi":"10.4103/glioma.glioma_27_20","DOIUrl":"https://doi.org/10.4103/glioma.glioma_27_20","url":null,"abstract":"Background and Aim: Many studies have demonstrated the value of neuronavigation guided by fluorescence staining for treating glioma patients. Here, we compared the rate of overall survival (OS) and the extent of tumor resection among patients who underwent surgery with neuronavigation and fluorescence versus conventional techniques. Materials and Methods: In this case-control observational study, data from 162 patients with supratentorial glioma who underwent surgery from January 2016 to November 2017 were retrospectively analyzed, including a neuronavigation and fluorescence treatment group (combined group, n = 53) and a conventional microsurgery group (control group, n = 109). The extent of tumor resection, World Health Organization (WHO) pathological grade, eloquent areas involved, tumor diameter, preoperative Karnofsky Performance Status score, underlying diseases, chemotherapy, hospitalization days, length of operation, intraoperative blood loss, and postoperative molecular pathological indictors were recorded. OS rates were compared using the Cox proportional hazards regression model. The study was approved by the Ethics Committee of Zhongnan Hospital of Wuhan University (approval No. 2019048). Results: The total resection rate was 60.4% in the combined group and 27.5% in the control group. Multivariate logistic regression analysis revealed that involvement of eloquent areas (odds ratio [OR] = 0.455, 95% confidence interval [CI]: 0.214–0.966, P = 0.040) and the use of the combined technique (OR = 3.634, 95% CI: 1.758–7.510, P < 0.001) were independent prognostic factors affecting total glioma resection. Eloquent areas were implicated in 79 patients. Multiple logistic regression analysis revealed that the combined technique (OR = 6.041, 95% CI: 1.705–21.403, P = 0.005) was an independent prognostic factor affecting total resection. The average follow-up period was 16.4 months. Cox regression analysis revealed that the WHO tumor grade (hazard ratio [HR] = 4.782, 95% CI: 1.620-14.119, P = 0.005), chemotherapy regimen (HR = 0.324, 95% CI: 0.181–0.579, P < 0.001), IDH mutation (HR = 0.366, 95% CI: 0.154–0.870, P = 0.023), and total resection (HR = 0.458, 95% CI: 0.248–0.846, P = 0.013) were independent factors affecting the prognosis of glioma patients. Conclusions: The use of neuronavigation with fluorescent staining appears to improve the tumor resection range and the OS rate, which is an independent factor affecting the degree of resection of supratentorial glioma. The WHO tumor grade, chemotherapy regimen, IDH mutation, and total resection were independent factors affecting the prognosis of glioma patients.","PeriodicalId":12731,"journal":{"name":"Glioma","volume":"4 1","pages":"5 - 11"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43519364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-10-01DOI: 10.4103/glioma.glioma_26_20
Yuchao Ma, J. Xiao
Glioblastoma is the most common primary brain tumor in adults. There is no standard treatment for residual or recurrent glioblastoma and the prognosis is poor. Here, we report the case of a 72-year-old woman with a glioblastoma who underwent subtotal resection, after which her tumor recurred rapidly. Adaptive hypofractionated radiotherapy combined with temozolomide and bevacizumab was administered, resulting in a long progression-free survival. The study was approved by the Ethics Committee of Cancer Hospital, Chinese Academy of Medical Sciences, China.
{"title":"Adaptive hypofractionated radiotherapy combined with chemotherapy and anti-angiogenic therapy for residual and recurrent glioblastoma after surgery: A case report","authors":"Yuchao Ma, J. Xiao","doi":"10.4103/glioma.glioma_26_20","DOIUrl":"https://doi.org/10.4103/glioma.glioma_26_20","url":null,"abstract":"Glioblastoma is the most common primary brain tumor in adults. There is no standard treatment for residual or recurrent glioblastoma and the prognosis is poor. Here, we report the case of a 72-year-old woman with a glioblastoma who underwent subtotal resection, after which her tumor recurred rapidly. Adaptive hypofractionated radiotherapy combined with temozolomide and bevacizumab was administered, resulting in a long progression-free survival. The study was approved by the Ethics Committee of Cancer Hospital, Chinese Academy of Medical Sciences, China.","PeriodicalId":12731,"journal":{"name":"Glioma","volume":"3 1","pages":"175 - 180"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46051341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-10-01DOI: 10.4103/glioma.glioma_28_20
Yong Huang, H. Ding, Y. Zhong
Spread along nerve fiber bundles is one of the most important modes of glioma invasion; however, the current guidelines for radiotherapy target areas recommend a 1–2-cm margin in all directions from the tumor border based on pretreatment imaging findings. In this article, we analyzed the relationship between edema and nerve fiber bundles in 60 glioma patients and aimed to clarify the effect of including edema on delineation of the target volume.
{"title":"Re-understanding of edema zone from the nerve fiber bundles: A narrative review","authors":"Yong Huang, H. Ding, Y. Zhong","doi":"10.4103/glioma.glioma_28_20","DOIUrl":"https://doi.org/10.4103/glioma.glioma_28_20","url":null,"abstract":"Spread along nerve fiber bundles is one of the most important modes of glioma invasion; however, the current guidelines for radiotherapy target areas recommend a 1–2-cm margin in all directions from the tumor border based on pretreatment imaging findings. In this article, we analyzed the relationship between edema and nerve fiber bundles in 60 glioma patients and aimed to clarify the effect of including edema on delineation of the target volume.","PeriodicalId":12731,"journal":{"name":"Glioma","volume":"3 1","pages":"162 - 167"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45393449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and Aim: Mutations in isocitrate dehydrogenase (IDH), co-deletion of 1p and 19q, loss or expression of the transcription regulator ATRX, and mutations in telomerase reverse transcriptase (TERT) gene promoters are intimately linked with diffuse gliomas. We further explored the roles of the key molecules in adulthood diffuse gliomas and their prognosis. Materials and Methods: A total of 413 patients who underwent primary surgery between 2009 and 2015 at Xuanwu Hospital, Beijing, China, were included in this observational study. All specimens from the patients were fixed in 10% neutral buffered formalin and embedded in paraffin. The mutational status of IDH1/2 and the TERT promoter was determined using polymerase chain reaction-based direct sequencing. The assay for the 1p and 19q co-deletion was conducted using fluorescence in situ hybridization. Overall- and progression-free survival was calculated using the Kaplan–Meier method and the log-rank test. The study was approved by the Ethics Committee of Xuanwu Hospital, Capital Medical University, China (approval No. [2019]004) on May 22, 2019. Results: We found that tumors characterized by multiple lesions were predominantly free of IDH mutations (P < 0.001). Gliomas with IDH mutations arose more often in the frontal and insular lobes than in the other lobes (P < 0.001). Rates of IDH mutations were higher in patients who had seizures or were without discomfort than in those who had other clinical symptoms (P = 0.0003). Of 119 patients with complete molecular information according to the 2016 World Health Organization classification of central nervous system tumors, 5 had oligoastrocytomas that had multiple genotypes – IDH1 mutation, loss of ATRX expression, and 1p/19q co-deletion – but lacked TERT promoter mutations. Patients with seizures or without discomfort who had IDH mutations had better outcomes than did other patients (P < 0.001). Patients whose tumors had IDH and TERT promoter mutations had a better prognosis than did other patients (P < 0.001). Among patients whose tumors had wild-type IDH, those with loss of ATRX survived longer than did others (P = 0.005). Conclusions: The status of both ATRX and the TERT promoter can indicate the prognosis in patients with IDH wild-type gliomas. The diagnosis that is based on clinical symptoms, histologic findings, and molecular analysis should be implemented as the diagnostic standard for patients with oligoastrocytomas.
{"title":"Diagnostic and prognostic implications of molecular status in Chinese adults with diffuse glioma: An observational study","authors":"Leiming Wang, Zhuo Li, Cuicui Liu, Liyan Zhang, Dandan Wang, Haijing Ge, Wei-Wei Xu, Yongjuan Fu, Yanning Cai, D. Lu, Y. Piao","doi":"10.4103/glioma.glioma_21_20","DOIUrl":"https://doi.org/10.4103/glioma.glioma_21_20","url":null,"abstract":"Background and Aim: Mutations in isocitrate dehydrogenase (IDH), co-deletion of 1p and 19q, loss or expression of the transcription regulator ATRX, and mutations in telomerase reverse transcriptase (TERT) gene promoters are intimately linked with diffuse gliomas. We further explored the roles of the key molecules in adulthood diffuse gliomas and their prognosis. Materials and Methods: A total of 413 patients who underwent primary surgery between 2009 and 2015 at Xuanwu Hospital, Beijing, China, were included in this observational study. All specimens from the patients were fixed in 10% neutral buffered formalin and embedded in paraffin. The mutational status of IDH1/2 and the TERT promoter was determined using polymerase chain reaction-based direct sequencing. The assay for the 1p and 19q co-deletion was conducted using fluorescence in situ hybridization. Overall- and progression-free survival was calculated using the Kaplan–Meier method and the log-rank test. The study was approved by the Ethics Committee of Xuanwu Hospital, Capital Medical University, China (approval No. [2019]004) on May 22, 2019. Results: We found that tumors characterized by multiple lesions were predominantly free of IDH mutations (P < 0.001). Gliomas with IDH mutations arose more often in the frontal and insular lobes than in the other lobes (P < 0.001). Rates of IDH mutations were higher in patients who had seizures or were without discomfort than in those who had other clinical symptoms (P = 0.0003). Of 119 patients with complete molecular information according to the 2016 World Health Organization classification of central nervous system tumors, 5 had oligoastrocytomas that had multiple genotypes – IDH1 mutation, loss of ATRX expression, and 1p/19q co-deletion – but lacked TERT promoter mutations. Patients with seizures or without discomfort who had IDH mutations had better outcomes than did other patients (P < 0.001). Patients whose tumors had IDH and TERT promoter mutations had a better prognosis than did other patients (P < 0.001). Among patients whose tumors had wild-type IDH, those with loss of ATRX survived longer than did others (P = 0.005). Conclusions: The status of both ATRX and the TERT promoter can indicate the prognosis in patients with IDH wild-type gliomas. The diagnosis that is based on clinical symptoms, histologic findings, and molecular analysis should be implemented as the diagnostic standard for patients with oligoastrocytomas.","PeriodicalId":12731,"journal":{"name":"Glioma","volume":"3 1","pages":"168 - 174"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44265484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-10-01DOI: 10.4103/glioma.glioma_29_20
Paramita Kundu, V. Santosh, P. Kondaiah
Cell competition among neighboring cells in a tissue gauges relative fitness in terms of growth and proliferation, which results in the death of cells with suboptimal fitness and the dominance of optimally or supraoptimally fit cells. It is conserved across multiple taxa and has indispensable functions in development, homeostasis, aging, and prevention of neoplastic growth, both in Drosophila and mammals. However, similar to how several key developmental pathways are subverted in cancer, cell competition mechanisms are often co-opted in the oncogenic transformation of cells in homeostatically stable tissues, and the role of this phenomenon in human cancer is attracting increasing interest. Grade IV glioblastomas (GBMs) are the most aggressive brain tumors that occur in adults. GBMs arise from glial cells and invariably result in tumor recurrence and death. Treatment of GBMs is complicated by the unique features of the anatomical context, including the dura, blood–brain barrier, glioma stem cells, necrosis, and extensive genetic and epigenetic heterogeneity. In this review, we discuss the evidence for cell competition elicited by genomic alterations in several key genes involved in early or late gliomagenesis, as well as activation of specific signaling pathways that aid competitive interactions with nonglial cell types like neurons to gain leverage in the colonization of brain niches. The role of intratumoral heterogeneity in conferring clonal dominance or cooperation resulting in therapeutic resistance in GBMs is also discussed.
{"title":"Mechanisms of cell competition in glioblastoma: A narrative review","authors":"Paramita Kundu, V. Santosh, P. Kondaiah","doi":"10.4103/glioma.glioma_29_20","DOIUrl":"https://doi.org/10.4103/glioma.glioma_29_20","url":null,"abstract":"Cell competition among neighboring cells in a tissue gauges relative fitness in terms of growth and proliferation, which results in the death of cells with suboptimal fitness and the dominance of optimally or supraoptimally fit cells. It is conserved across multiple taxa and has indispensable functions in development, homeostasis, aging, and prevention of neoplastic growth, both in Drosophila and mammals. However, similar to how several key developmental pathways are subverted in cancer, cell competition mechanisms are often co-opted in the oncogenic transformation of cells in homeostatically stable tissues, and the role of this phenomenon in human cancer is attracting increasing interest. Grade IV glioblastomas (GBMs) are the most aggressive brain tumors that occur in adults. GBMs arise from glial cells and invariably result in tumor recurrence and death. Treatment of GBMs is complicated by the unique features of the anatomical context, including the dura, blood–brain barrier, glioma stem cells, necrosis, and extensive genetic and epigenetic heterogeneity. In this review, we discuss the evidence for cell competition elicited by genomic alterations in several key genes involved in early or late gliomagenesis, as well as activation of specific signaling pathways that aid competitive interactions with nonglial cell types like neurons to gain leverage in the colonization of brain niches. The role of intratumoral heterogeneity in conferring clonal dominance or cooperation resulting in therapeutic resistance in GBMs is also discussed.","PeriodicalId":12731,"journal":{"name":"Glioma","volume":"3 1","pages":"154 - 161"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49634392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-10-01DOI: 10.4103/glioma.glioma_30_20
L. Kong, Jiade J. Lu
This narrative review summarizes the current status of the use of particle radiation therapy on the treatment of adult malignant gliomas. Due to the unique physical property, particle (e.g., proton or carbon-ion) beam radiation therapy can improve radiation dose distribution, thereby therapeutic radio for patients with brain malignancy. Therefore, particle beam radiation therapy is associated with low adverse events which have implications for improving quality of life for long-term survivors. In addition, there is a potential for safe dose escalation in selected patients. Malignant glioma is considered radioresistant; thus, particle beams of higher relative biological effectiveness, carbon-ion beam, for example, may further improve disease control in theory. Data on carbon-ion beam RT alone for the management of brain tumor are scarce. Most literature described proton beam alone or the use of combined proton/photon and carbon-ion beam boost for the treatment of glioma. Existing clinical evidence describes virtually no acute high-grade toxicities and limited late effects. Prospective clinical trials are needed to confirm the improved efficacy and favorable toxicity profile of particle beam radiation therapy on adult malignant glioma described in retrospective studies. Currently, multiple prospective trials are ongoing to answer such questions.
{"title":"Particle radiation therapy in the management of adult high-grade glioma: A narrative review","authors":"L. Kong, Jiade J. Lu","doi":"10.4103/glioma.glioma_30_20","DOIUrl":"https://doi.org/10.4103/glioma.glioma_30_20","url":null,"abstract":"This narrative review summarizes the current status of the use of particle radiation therapy on the treatment of adult malignant gliomas. Due to the unique physical property, particle (e.g., proton or carbon-ion) beam radiation therapy can improve radiation dose distribution, thereby therapeutic radio for patients with brain malignancy. Therefore, particle beam radiation therapy is associated with low adverse events which have implications for improving quality of life for long-term survivors. In addition, there is a potential for safe dose escalation in selected patients. Malignant glioma is considered radioresistant; thus, particle beams of higher relative biological effectiveness, carbon-ion beam, for example, may further improve disease control in theory. Data on carbon-ion beam RT alone for the management of brain tumor are scarce. Most literature described proton beam alone or the use of combined proton/photon and carbon-ion beam boost for the treatment of glioma. Existing clinical evidence describes virtually no acute high-grade toxicities and limited late effects. Prospective clinical trials are needed to confirm the improved efficacy and favorable toxicity profile of particle beam radiation therapy on adult malignant glioma described in retrospective studies. Currently, multiple prospective trials are ongoing to answer such questions.","PeriodicalId":12731,"journal":{"name":"Glioma","volume":"3 1","pages":"149 - 153"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41898079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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