Brainstem Infiltration Predicts Survival in Patients With High-grade Gliomas Treated With Chemoradiotherapy

• Published in: Anticancer research Vol. 41; no. 5; pp. 2583 - 2589
• Main Authors: Anami, Shimpei, Fukai, Junya, Hama, Mizuki, Awaya, Azusa, Inagaki, Takaya, Chiba, Takahiro, Noda, Yasutaka, Kanemura, Yonehiro, Nakao, Naoyuki, Sonomura, Tetsuo
• Format: Journal Article
• Language: English
• Published: Greece International Institute of Anticancer Research 01.05.2021
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Basal ganglia; Basal Ganglia - immunology; Basal Ganglia - pathology; Brain stem; Brain Stem - immunology; Brain Stem - pathology; Chemoradiotherapy; Chemoradiotherapy - adverse effects; Chemotherapy; Disease-Free Survival; DNA Modification Methylases - genetics; DNA Repair Enzymes - genetics; Female; Ganglia; Gene Expression Regulation, Neoplastic - immunology; Glioma; Glioma - drug therapy; Glioma - immunology; Glioma - pathology; Glioma - radiotherapy; Humans; Infiltration; Lymphocytes, Tumor-Infiltrating - immunology; Lymphocytes, Tumor-Infiltrating - pathology; Male; Medical prognosis; Middle Aged; Multivariate analysis; Neoplasm Grading; Patients; Prognosis; Promoter Regions, Genetic - genetics; Radiation therapy; Surgery; Survival; Tumor Suppressor Proteins - genetics; basal ganglia; brainstem infiltration; Predictor of survival; MGMT promoter; high-grade glioma
• ISSN: 0250-7005; 1791-7530
• DOI: 10.21873/anticanres.15037

High-grade gliomas have a poor prognosis despite standard treatment. The aim of the study was to identify new prognostic factors to select patients who need more intense treatment. Forty-three consecutive patients underwent surgery plus chemoradiotherapy for pathologically diagnosed high-grade gliomas (grade III, IV). The median survival time was 989 days, and the 1-year survival rate was 87.6%. Among patients with grade IV disease, the median survival time, 1-year, and 2-year survival rate were 814 days, 82.6%, and 58.7%, respectively. In the univariate analysis, unmethylated MGMT promoter (p=0.0495), brainstem infiltration (p=0.0004), basal ganglia as the primary lesion site (p=0.0056), 3-dimensional conformal radiotherapy (p=0.0286), and <50 Gy (p=0.0049) were associated with a poor prognosis. In the multivariate analysis, only brainstem infiltration retained significance (HR for death, 0.21; 95% CI=0.06-0.70; p=0.011). Brainstem infiltration is a novel prognostic factor for poor prognosis in patients with high-grade gliomas.