Eike Steidl, Katharina Johanna Filipski, Pia Susan Zeiner, Marlies Wagner, Emmanouil Fokas, Marie-Thérèse Forster, Michael Wilfried Ronellenfitsch, Iris Divé, Joachim Peter Steinbach, Patrick Nikolaus Harter, Roy Oliver Bähr
- Purpose: Classification and treatment of WHO grade II/III gliomas have dramatically changed. Implementing molecular markers into the WHO classification raised discussions about the significance of grading and clinical trials showed overall survival (OS) benefits for combined radiochemotherapy. As molecularly stratified treatment data outside clinical trials are scarce, we conducted this retrospective study.
Methods: We identified 343 patients (1995–2015) with newly diagnosed WHO grade II/III gliomas and analyzed molecular markers, patient characteristics, symptoms, histology, treatment, time to treatment failure (TTF) and OS.
Results: IDH-status was available for all patients (259 mutant, 84 IDH1-R132H-non-mutant). Molecular subclassification was possible in 173 tumors, resulting in diagnosis of 80 astrocytomas and 93 oligodendrogliomas. WHO grading remained significant for OS in astrocytomas/IDH1-R132H-non-mutant gliomas (p < 0.01) but not for oligodendroglioma (p = 0.27). Chemotherapy (and temozolomide in particular) showed inferior OS compared to radiotherapy in astrocytomas (median 6.1/12.1 years; p = 0.03) and oligodendrogliomas (median 13.2/not reached (n.r.) years; p = 0.03). While radiochemotherapy improved TTF in oligodendroglioma (median radiochemotherapy n.r./chemotherapy 3.8/radiotherapy 7.3 years; p < 0.001/ = 0.06; OS data immature) the effect, mainly in combination with temozolomide, was weaker in astrocytomas (median radiochemotherapy 6.7/chemotherapy 2.3/radiotherapy 2.0 years; p < 0.001/ = 0.11) and did not translate to improved OS (median 8.4 years).
Conclusion: This is one of the largest retrospective, real-life datasets reporting treatment and outcome in low-grade gliomas incorporating molecular markers. Current histologic grading features remain prognostic in astrocytomas while being insignificant in oligodendroglioma with interfering treatment effects. Chemotherapy (temozolomide) was less effective than radiotherapy in both astrocytomas and oligodendrogliomas while radiochemotherapy showed the highest TTF in oligodendrogliomas.
MetadatenAuthor: | Eike SteidlORCiDGND, Katharina Johanna FilipskiGND, Pia Susan ZeinerORCiD, Marlies WagnerORCiDGND, Emmanouil FokasORCiDGND, Marie-Thérèse ForsterORCiDGND, Michael Wilfried RonellenfitschORCiDGND, Iris DivéGND, Joachim Peter SteinbachORCiDGND, Patrick Nikolaus HarterORCiDGND, Roy Oliver BährGND |
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URN: | urn:nbn:de:hebis:30:3-637423 |
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DOI: | https://doi.org/10.1007/s00432-021-03511-y |
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ISSN: | 1432-1335 |
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Parent Title (English): | Journal of cancer research and clinical oncology |
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Publisher: | Springer |
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Place of publication: | Berlin ; Heidelberg |
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Document Type: | Article |
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Language: | English |
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Date of Publication (online): | 2021/02/04 |
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Date of first Publication: | 2021/02/04 |
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Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
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Release Date: | 2023/01/31 |
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Tag: | Astrocytoma; Grading; Low grade glioma; Oligodendroglioma; Temozolomide; Treatment outcome |
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Volume: | 147 |
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Issue: | 8 |
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Page Number: | 11 |
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First Page: | 2373 |
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Last Page: | 2383 |
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Note: | Open Access funding enabled and organized by Projekt DEAL. |
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HeBIS-PPN: | 505602423 |
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Institutes: | Medizin |
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Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
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Sammlungen: | Universitätspublikationen |
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Licence (German): | Creative Commons - Namensnennung 4.0 |
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