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

TitleRadiotherapy-induced glioblastoma: distinct differences in overall survival, tumor location, pMGMT methylation and primary tumor epidemiology in Hong Kong chinese patients
Authors
KeywordsGlioblastoma
methyguanine methyltranferase
radiation-induced
radiotherapy-induced
Issue Date2021
Citation
British Journal of Neurosurgery, 2021 How to Cite?
AbstractIntroduction: 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 pMGMT 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 pMGMT 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.
Persistent Identifierhttp://hdl.handle.net/10722/325516
ISSN
2023 Impact Factor: 1.0
2023 SCImago Journal Rankings: 0.402
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWoo, Peter Y.M.-
dc.contributor.authorLee, Jennifer W.Y.-
dc.contributor.authorLam, Sandy W.-
dc.contributor.authorPu, Jenny K.S.-
dc.contributor.authorChan, Danny T.M.-
dc.contributor.authorMak, Calvin H.K.-
dc.contributor.authorHo, Jason M.K.-
dc.contributor.authorWong, Sui To-
dc.contributor.authorPo, Yin Chung-
dc.contributor.authorLee, Michael W.Y.-
dc.contributor.authorChan, Kwong Yau-
dc.contributor.authorPoon, Wai Sang-
dc.date.accessioned2023-02-27T07:33:55Z-
dc.date.available2023-02-27T07:33:55Z-
dc.date.issued2021-
dc.identifier.citationBritish Journal of Neurosurgery, 2021-
dc.identifier.issn0268-8697-
dc.identifier.urihttp://hdl.handle.net/10722/325516-
dc.description.abstractIntroduction: 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 pMGMT 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 pMGMT 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.-
dc.languageeng-
dc.relation.ispartofBritish Journal of Neurosurgery-
dc.subjectGlioblastoma-
dc.subjectmethyguanine methyltranferase-
dc.subjectradiation-induced-
dc.subjectradiotherapy-induced-
dc.titleRadiotherapy-induced glioblastoma: distinct differences in overall survival, tumor location, pMGMT methylation and primary tumor epidemiology in Hong Kong chinese patients-
dc.typeArticle-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1080/02688697.2021.1881445-
dc.identifier.scopuseid_2-s2.0-85100841822-
dc.identifier.eissn1360-046X-
dc.identifier.isiWOS:000617635400001-

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