Format

Send to

Choose Destination
J Neurooncol. 2014 Jun;118(2):321-328. doi: 10.1007/s11060-014-1434-1. Epub 2014 Apr 16.

Clinical management and outcome of histologically verified adult brainstem gliomas in Switzerland: a retrospective analysis of 21 patients.

Author information

1
Department of Neurology, Cantonal Hospital St. Gallen, Rorschacherstr. 95, 9007, St. Gallen, Switzerland. thomas.hundsberger@kssg.ch.
2
Department of Hematology and Oncology, Cantonal Hospital St. Gallen, Rorschacherstr. 95, 9007, St. Gallen, Switzerland. thomas.hundsberger@kssg.ch.
3
Department of Neurology, and Brain Tumor Center, University Hospital Zurich, Zurich, Switzerland.
4
Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
5
Department of Radiation Oncology, Cantonal Hospital St Gallen, St. Gallen, Switzerland.
6
Department of Neurology, Cantonal Hospital Aarau, Aarau, Switzerland.
7
Department of Oncology, and Brain Tumor Center, University Hospital Zurich, Zurich, Switzerland.

Abstract

Because of low incidence, mixed study populations and paucity of clinical and histological data, the management of adult brainstem gliomas (BSGs) remains non-standardized. We here describe characteristics, treatment and outcome of patients with exclusively histologically confirmed adult BSGs. A retrospective chart review of adults (age >18 years) was conducted. BSG was defined as a glial tumor located in the midbrain, pons or medulla. Characteristics, management and outcome were analyzed. Twenty one patients (17 males; median age 41 years) were diagnosed between 2004 and 2012 by biopsy (n = 15), partial (n = 4) or complete resection (n = 2). Diagnoses were glioblastoma (WHO grade IV, n = 6), anaplastic astrocytoma (WHO grade III, n = 7), diffuse astrocytoma (WHO grade II, n = 6) and pilocytic astrocytoma (WHO grade I, n = 2). Diffuse gliomas were mainly located in the pons and frequently showed MRI contrast enhancement. Endophytic growth was common (16 vs. 5). Postoperative therapy in low-grade (WHO grade I/II) and high-grade gliomas (WHO grade III/IV) consisted of radiotherapy alone (three in each group), radiochemotherapy (2 vs. 6), chemotherapy alone (0 vs. 2) or no postoperative therapy (3 vs. 1). Median PFS (24.1 vs. 5.8 months; log-rank, p = 0.009) and mOS (30.5 vs. 11.5 months; log-rank, p = 0.028) was significantly better in WHO grade II than in WHO grade III/IV tumors. Second-line therapy considerably varied. Histologically verification of adult BSGs is feasible and has an impact on postoperative treatment. Low-grade gliomas can simple be followed or treated with radiotherapy alone. Radiochemotherapy with temozolomide can safely be prescribed for high-grade gliomas without additional CNS toxicities.

PMID:
24736829
DOI:
10.1007/s11060-014-1434-1
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Springer Icon for Zurich Open Access Repository and Archive
Loading ...
Support Center