Cancer Research and Treatment

Original Articles

Pediatric cancer

Long-term Outcomes of Protocol-Based Treatment for Newly Diagnosed Medulloblastoma: Won Kee Ahn, Seung Min Hahn, Hong In Yoon, Jeongshim Lee, Eun Kyung Park, Kyu Won Shim, Dong Seok Kim, Chang-Ok Suh, Se Hoon Kim, Chuhl Joo Lyu, Jung Woo Han; Cancer Res Treat. 2024;56(2):652-664. Published online November 30, 2023; DOI: https://doi.org/10.4143/crt.2023.865

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Purpose
The Korean Society of Pediatric Neuro-Oncology (KSPNO) conducted treatment strategies for children with medulloblastoma (MB) by using alkylating agents for maintenance chemotherapy or tandem high-dose chemotherapy (HDC) with autologous stem cell rescue (ASCR) according to the risk stratification. The purpose of the study was to assess treatment outcomes and complications based on risk-adapted treatment and HDC.
Materials and Methods
Fifty-nine patients diagnosed with MB were enrolled in this study. Patients in the standard-risk (SR) group received radiotherapy (RT) after surgery and chemotherapy using the KSPNO M051 regimen. Patients in the high-risk (HR) group received two and four chemotherapy cycles according to the KSPNO S081 protocol before and after reduced RT for age following surgery and two cycles of tandem HDC with ASCR consolidation treatment.
Results
In the SR group, 24 patients showed 5-year event-free survival (EFS) and overall survival (OS) estimates of 86.7% (95% confidence interval [CI], 73.6 to 100) and 95.8% (95% CI, 88.2 to 100), respectively. In the HR group, more infectious complications and mortality occurred during the second HDC than during the first. In the HR group, the 5-year EFS and OS estimates were 65.5% (95% CI, 51.4 to 83.4) and 72.3% (95% CI, 58.4 to 89.6), respectively.
Conclusion
High intensity of alkylating agents for SR resulted in similar outcomes but with a high incidence of hematologic toxicity. Tandem HDC with ASCR for HR induced favorable EFS and OS estimates compared to those reported previously. However, infectious complications and treatment-related mortalities suggest that a reduced chemotherapy dose is necessary, especially for the second HDC.

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Ferroptosis Transcriptional Regulation and Prognostic Impact in Medulloblastoma Subtypes Revealed by RNA-Seq
Christophe Desterke, Yuanji Fu, Jenny Bonifacio-Mundaca, Claudia Monge, Pascal Pineau, Jorge Mata-Garrido, Raquel Francés
Antioxidants.2025; 14(1): 96. CrossRef

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Central nervous system

Survival, Prognostic Factors, and Volumetric Analysis of Extent of Resection for Anaplastic Gliomas: Je Beom Hong, Tae Hoon Roh, Seok-Gu Kang, Se Hoon Kim, Ju Hyung Moon, Eui Hyun Kim, Sung Soo Ahn, Hye Jin Choi, Jaeho Cho, Chang-Ok Suh, Jong Hee Chang; Cancer Res Treat. 2020;52(4):1041-1049. Published online April 23, 2020; DOI: https://doi.org/10.4143/crt.2020.057

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Purpose
The aim of this study is to evaluate the survival rate and prognostic factors of anaplastic gliomas according to the 2016 World Health Organization classification, including extent of resection (EOR) as measured by contrast-enhanced T1-weighted magnetic resonance imaging (MRI) and the T2-weighted MRI.
Materials and Methods
The records of 113 patients with anaplastic glioma who were newly diagnosed at our institute between 2000 and 2013 were retrospectively reviewed. There were 62 cases (54.9%) of anaplastic astrocytoma, isocitrate dehydrogenase (IDH) wild-type (AAw), 18 cases (16.0%) of anaplastic astrocytoma, IDH-mutant, and 33 cases (29.2%) of anaplastic oligodendroglioma, IDH-mutant and 1p/19q-codeleted.
Results
The median overall survival (OS) was 48.4 months in the whole anaplastic glioma group and 21.5 months in AAw group. In multivariate analysis, age, preoperative Karnofsky Performance Scale score, O⁶-methylguanine-DNA methyltransferase (MGMT) methylation status, postoperative tumor volume, and EOR measured from the T2 MRI sequence were significant prognostic factors. The EOR cut-off point for OS measured in contrast-enhanced T1-weighted MRI and T2-weighted MRI were 99.96% and 85.64%, respectively.
Conclusions
We found that complete resection of the contrast-enhanced portion (99.96%) and more than 85.64% resection of the non-enhanced portion of the tumor have prognostic impacts on patient survival from anaplastic glioma.

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AQP1 as a novel biomarker to predict prognosis and tumor immunity in glioma patients
Xiang Gao, Wenqu Jiang, Guofeng Zhu, Zelong Xing, Pengbo Zhu, Zunliang Ke, Qiwei Huang
Oncologie.2024; 26(1): 117. CrossRef
Decapping enzyme 2 is a novel immune-related biomarker that predicts poor prognosis in glioma
Yuran Mei, Qiaoli Lv, Zilong Tan, Zhe Zhang, Yulong Ji, Shuhui Chen, Xiaoli Shen
Biotechnology and Genetic Engineering Reviews.2024; 40(4): 4262. CrossRef
Decision system for extent of resection in WHO grade 3 gliomas: a Chinese Glioma Genome Atlas database analysis
Ziming Hou, Jie Hu, Xing Liu, Zeya Yan, Kenan Zhang, Shengyu Fang, Tao Jiang, Yinyan Wang
Journal of Neuro-Oncology.2023; 164(2): 461. CrossRef
The Impact of Extent of Resection on the Prognosis of Glioblastoma Multiforme: A Systematic Review and Meta-analysis
Dipak Chaulagain, Volodymyr Smolanka, Andriy Smolanka, Sunil Munakomi
Open Access Macedonian Journal of Medical Sciences.2022; 10(F): 345. CrossRef
Relative T2-FLAIR signal intensity surrounding residual cavity is associated with survival prognosis in patients with lower-grade gliomas
Tao Yuan, Zhen Gao, Fei Wang, Jia-Liang Ren, Tianda Wang, Hongbo Zhong, Guodong Gao, Guanmin Quan
Frontiers in Oncology.2022;[Epub] CrossRef
SLC39A1 contribute to malignant progression and have clinical prognostic impact in gliomas
Peng Wang, Jingjing Zhang, Shuai He, Boan Xiao, Xiaobin Peng
Cancer Cell International.2020;[Epub] CrossRef

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Concurrent Chemoradiotherapy with Temozolomide Followed by Adjuvant Temozolomide for Newly Diagnosed Glioblastoma Patients: A Retrospective Multicenter Observation Study in Korea: Byung Sup Kim, Ho Jun Seol, Do-Hyun Nam, Chul-Kee Park, Il Han Kim, Tae Min Kim, Jeong Hoon Kim, Young Hyun Cho, Sang Min Yoon, Jong Hee Chang, Seok-Gu Kang, Eui Hyun Kim, Chang-Ok Suh, Tae-Young Jung, Kyung-Hwa Lee, Chae-Yong Kim, In Ah Kim, Chang-Ki Hong, Heon Yoo, Jin Hee Kim, Shin-Hyuk Kang, Min Kyu Kang, Eun-Young Kim, Sun-Hwan Kim, Dong-Sup Chung, Sun-Chul Hwang, Joon-Ho Song, Sung Jin Cho, Sun-Il Lee, Youn-Soo Lee, Kook-Jin Ahn, Se Hoon Kim, Do Hun Lim, Ho-Shin Gwak, Se-Hoon Lee, Yong-Kil Hong; Cancer Res Treat. 2017;49(1):193-203. Published online June 27, 2016; DOI: https://doi.org/10.4143/crt.2015.473

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Purpose
The purpose of this study was to investigate the feasibility and survival benefits of combined treatment with radiotherapy and adjuvant temozolomide (TMZ) in a Korean sample.
Materials and Methods
A total of 750 Korean patients with histologically confirmed glioblastoma multiforme, who received concurrent chemoradiotherapy with TMZ (CCRT) and adjuvant TMZ from January 2006 until June 2011, were analyzed retrospectively.
Results
After the first operation, a gross total resection (GTR), subtotal resection (STR), partial resection (PR), biopsy alone were achieved in 388 (51.7%), 159 (21.2%), 96 (12.8%), and 107 (14.3%) patients,respectively. The methylation status of O⁶-methylguanine-DNA methyltransferase (MGMT) was reviewed retrospectively in 217 patients. The median follow-up period was 16.3 months and the median overall survival (OS) was 17.5 months. The actuarial survival rates at the 1-, 3-, and 5-year OS were 72.1%, 21.0%, and 9.0%, respectively. The median progression-free survival (PFS) was 10.1 months, and the actuarial PFS at 1-, 3-, and 5-year PFS were 42.2%, 13.0%, and 7.8%, respectively. The patients who received GTR showed a significantly longer OS and PFS than those who received STR, PR, or biopsy alone, regardless of the methylation status of the MGMT promoter. Patients with a methylated MGMT promoter also showed a significantly longer OS and PFS than those with an unmethylated MGMT promoter. Patients who received more than six cycles of adjuvant TMZ had a longer OS and PFS than those who received six or fewer cycles. Hematologic toxicity of grade 3 or 4 was observed in 8.4% of patients during the CCRT period and in 10.2% during the adjuvant TMZ period.
Conclusion
Patients treated with CCRT followed by adjuvant TMZ had more favorable survival rates and tolerable toxicity than those who did not undergo this treatment.

Citations

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Efficacy and safety of carmustine wafers, followed by radiation, temozolomide, and bevacizumab therapy, for newly diagnosed glioblastoma with maximal resection
Masayuki Kanamori, Ichiyo Shibahara, Yoshiteru Shimoda, Yukinori Akiyama, Takaaki Beppu, Shigeo Ohba, Toshiyuki Enomoto, Takahiro Ono, Yuta Mitobe, Mitsuto Hanihara, Yohei Mineharu, Joji Ishida, Kenichiro Asano, Yasuyuki Yoshida, Manabu Natsumeda, Sadahir
International Journal of Clinical Oncology.2025; 30(1): 51. CrossRef
Iron Mediates Radiation-Induced Glioblastoma Cell Diffusion
Stephenson Boakye Owusu, Akalanka B. Ekanayake, Alexei V. Tivanski, Michael S. Petronek
International Journal of Molecular Sciences.2025; 26(10): 4755. CrossRef
Letter to the Editor Regarding Cerebral Blood Flow Role in Delineating Treatment Effect from True Tumor Progression in Glioblastoma Multiforme
Inibehe Ime Okon, Tolulope Judah Gbayisomore, Samuel Berchi Kankam, Mohammad Jalloh
World Neurosurgery.2024; 186: 269. CrossRef
NTRK-fused central nervous system tumours: clinicopathological and genetic insights and response to TRK inhibitors
Eric Eunshik Kim, Chul-Kee Park, Seung-Ki Kim, Ji Hoon Phi, Sun Ha Paek, Jung Yoon Choi, Hyoung Jin Kang, Joo Ho Lee, Jae Kyung Won, Hongseok Yun, Sung-Hye Park
Acta Neuropathologica Communications.2024;[Epub] CrossRef
The Korean Society for Neuro-Oncology (KSNO) Guideline for the Management of Brain Tumor Patients During the Crisis Period: A Consensus Recommendation Using the Delphi Method (Version 2023.1)
Min-Sung Kim, Se-Il Go, Chan Woo Wee, Min Ho Lee, Seok-Gu Kang, Kyeong-O Go, Sae Min Kwon, Woohyun Kim, Yun-Sik Dho, Sung-Hye Park, Youngbeom Seo, Sang Woo Song, Stephen Ahn, Hyuk-Jin Oh, Hong In Yoon, Sea-Won Lee, Joo Ho Lee, Kyung Rae Cho, Jung Won Choi
Brain Tumor Research and Treatment.2023; 11(2): 123. CrossRef
Lymphoproliferative disorder during temozolomide therapy; a representative case of a formidable complication and management challenges
Daisuke Sato, Hirokazu Takami, Shunsaku Takayanagi, Kazuki Taoka, Mariko Tanaka, Reiko Matsuura, Shota Tanaka, Nobuhito Saito
BMC Neurology.2023;[Epub] CrossRef
Glioma angiogenesis is boosted by ELK3 activating the HIF-1$$alpha$$/VEGF-A signaling axis
Mou Yueyang, Hu Yaqin, Xue Guolian, Zhao Wenjian, Jiao Yang, Li Chen, Cao Haiyan, Chao Min, Deng Jianping, Dai Penggao, Zhu Hongli, Wang Liang
BMC Cancer.2023;[Epub] CrossRef
Levetiracetam as a sensitizer of concurrent chemoradiotherapy in newly diagnosed glioblastoma: An open‐label phase 2 study
Kihwan Hwang, Junhyung Kim, Seok‐Gu Kang, Tae‐Young Jung, Jeong Hoon Kim, Se‐Hyuk Kim, Shin‐Hyuk Kang, Yong‐Kil Hong, Tae Min Kim, Yu Jung Kim, Byung Se Choi, Jong Hee Chang, Chae‐Yong Kim
Cancer Medicine.2022; 11(2): 371. CrossRef
Prognostic Value and Risk Factors of Treatment-Related Lymphopenia in Malignant Glioma Patients Treated With Chemoradiotherapy: A Systematic Review and Meta-Analysis
Yongchao Zhang, Shichao Chen, Hualei Chen, Shanshan Chen, Zhen Li, Enshan Feng, Wei Li
Frontiers in Neurology.2022;[Epub] CrossRef
PrACTiC: A Predictive Algorithm for Chemoradiotherapy-Induced Cytopenia in Glioblastoma Patients
Alireza Amouheidari, Zahra Alirezaei, Stefan Rauh, Masoud Hassanpour, Ozkan Kanat
Journal of Oncology.2022; 2022: 1. CrossRef
Relapsing High—Grade Glioma from Peritumoral Zone: Critical Review of Radiotherapy Treatment Options
Maria Chiara Lo Greco, Roberto Milazzotto, Rocco Luca Emanuele Liardo, Grazia Acquaviva, Madalina La Rocca, Roberto Altieri, Francesco Certo, Giuseppe Maria Barbagallo, Antonio Basile, Pietro Valerio Foti, Stefano Palmucci, Stefano Pergolizzi, Antonio Pon
Brain Sciences.2022; 12(4): 416. CrossRef
Effect of Choline Alphoscerate on the Survival of Glioblastoma Patients: A Retrospective, Single-Center Study
Yeong Jin Kim, Tae-Kyu Lee, Myung-Giun Noh, Tae-Young Jung, In-Young Kim, Shin Jung, Kyung-Hwa Lee, Kyung-Sub Moon
Journal of Clinical Medicine.2022; 11(20): 6052. CrossRef
Evaluating survival in subjects with astrocytic brain tumors by dynamic susceptibility-weighted perfusion MR imaging
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Prognostic value of test(s) for O6-methylguanine–DNA methyltransferase (MGMT) promoter methylation for predicting overall survival in people with glioblastoma treated with temozolomide
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Mixed malignant glioblastoma and schwannoma in spinal cord with metachronous ependymoma: A case report
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Long Intergenic Non-Protein Coding RNA 1094 Promotes Initiation and Progression of Glioblastoma by Promoting microRNA-577-Regulated Stabilization of Brain-Derived Neurotrophic Factor

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Patterns of Failure Following Multimodal Treatment for Medulloblastoma: Long-Term Follow-up Results at a Single Institution: Dong Soo Lee, Jaeho Cho, Se Hoon Kim, Dong-Seok Kim, Kyu Won Shim, Chuhl Joo Lyu, Jung Woo Han, Chang-Ok Suh; Cancer Res Treat. 2015;47(4):879-888. Published online December 8, 2014; DOI: https://doi.org/10.4143/crt.2014.067

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Purpose
The purpose of this study is to investigate the long-term results and appropriateness of radiation therapy (RT) for medulloblastoma (MB) at a single institution. Materials and Methods We analyzed the clinical outcomes of 106 patients with MB who received RT between January 1992 and October 2009. The median age was 7 years (range, 0 to 50 years), and the proportion of M0, M1, M2, and M3 stages was 60.4%, 8.5%, 4.7%, and 22.6%, respectively. The median total craniospinal irradiation (CSI) and posterior fossa tumor bed dose in 102 patients (96.2%) treated with CSI was 36 Gy and 54 Gy, respectively. Results The median follow-up period in survivors was 132 months (range, 31 to 248 months). A gradual improvement in survival outcomes was observed, with 5-year overall survival rates of 61.5% in 1990s increasing to 73.6% in 2000s. A total of 29 recurrences (27.4%) developed at the following sites: five (17.2%) in the tumor bed; five (17.2%) in the posterior fossa other than the tumor bed; nine (31%) in the supratentorium; and six (20.7%) in the spinal subarachnoid space only. The four remaining patients showed multiple site recurrences. Among 12 supratentorial recurrences, five cases recurred in the subfrontal areas. Although the frequency of posterior fossa/tumor bed recurrences was significantly high among patients treated with subtotal resection, other site (other intracranial/spinal) recurrences were more common among patients treated with gross tumor removal (p=0.016). There was no case of spinal subarachnoid space relapse from desmoplastic/extensive nodular histological subtypes. Conclusion Long-term follow-up results and patterns of failure confirmed the importance of optimal RT dose and field arrangement. More tailored multimodal strategies and proper CSI technique may be the cornerstones for improving treatment outcomes in MB patients.

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Remote Supratentorial Recurrent Medulloblastoma: Case Study and Literature Review
Asimina Dominari, Elias Antoniades, Antonio Capiccelo, Emmanuil Hatzipantelis, Nikolaos Foroglou
Asian Journal of Neurosurgery.2022; 17(02): 286. CrossRef
Sequential improvement in paediatric medulloblastoma outcomes in a low-and-middle-income country setting over three decades
Johann Riedemann, Anthony Figaji, Alan Davidson, Clare Stannard, Komala Pillay, Tracy Kilborn, Jeannette Parkes
South African Journal of Oncology.2021;[Epub] CrossRef
Multifocal recurrence of medulloblastoma: a long follow-up case study
Benny Zulkarnaien, Edwin Suharlim, Eka Susanto, Soehartati Argadikoesoema Gondhowiardjo
Medical Journal of Indonesia.2020; 29(1): 93. CrossRef
Radiotherapy Advances in Paediatric Medulloblastoma Treatment
L. Padovani, G. Horan, T. Ajithkumar
Clinical Oncology.2019; 31(3): 171. CrossRef
Craniospinal irradiation using helical tomotherapy for central nervous system tumors
Sanziana R.I. Schiopu, Gregor Habl, Matthias Häfner, Sonja Katayama, Klaus Herfarth, Juergen Debus, Florian Sterzing
Journal of Radiation Research.2017;[Epub] CrossRef
Highly Conformal Craniospinal Radiotherapy Techniques Can Underdose the Cranial Clinical Target Volume if Leptomeningeal Extension through Skull Base Exit Foramina is not Contoured
D.J. Noble, T. Ajithkumar, J. Lambert, I. Gleeson, M.V. Williams, S.J. Jefferies
Clinical Oncology.2017; 29(7): 439. CrossRef
Long-term toxic effects of proton radiotherapy for paediatric medulloblastoma: a phase 2 single-arm study
Torunn I Yock, Beow Y Yeap, David H Ebb, Elizabeth Weyman, Bree R Eaton, Nicole A Sherry, Robin M Jones, Shannon M MacDonald, Margaret B Pulsifer, Beverly Lavally, Annah N Abrams, Mary S Huang, Karen J Marcus, Nancy J Tarbell
The Lancet Oncology.2016; 17(3): 287. CrossRef

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