Case report of patient with gliosarcoma treated with surgery, radio-chemotherapy and Boswellia sacra preparation

Introduction Gliosarcoma (GS) is a rare kind of glioblastoma (GBM) consisting of gliomatous and sarcomatous components. GS is more aggressive with worse prognosis than GBM. Median survival for GBM following diagnosis is 12–15 months, and for GS is 7 months. Current therapeutic strategies for both are the same and involve surgery, temozolomide (TMZ) and radiation therapy (RT). Decreasing glucocorticoid increase overall survival [1]. A recent study showed that the boswellic acid of Boswellia sacra increased the anticancer activities of TMZ significantly [2].

Aim We report the case of a patient with GS with standard treatment plus Boswellia sacra preparation (BS). Up to our knowledge, this is the first case reported.

Method A 51-year-old surgeon from Iraq, treated in Jordan, developed visual deficits, headache and dizziness. Brain-MRI showed a huge brain mass with extensive edema. He underwent gross tumor resection. Definitive histology revealed GS. As a result, he was treated with radio-chemotherapy, TMZ and BS. He was started on BS 1800 mg PO daily, which was increased to 5400 mg for a total of 8 months. He also received dexamethasone 16 mg per os at the end of the radiotherapy, 1 mg twice daily.

Results The patient had a regular follow up with brain MRI. He had three controls. They showed progressive reduction in tumor size (from 6.5 × 5.5 to 3.8 × 3.3 cm) und edema of about 30%. We followed him 8 months, then he immigrated to Australia and we lost our contacts.

Conclusion The result is promising. BS is potentially saving steroids [3] and may influence tumor response to radiotherapy positively. Our result needs to be validated in larger studies.

Publikationsverlauf

Artikel online veröffentlicht:
13. Juni 2022

• References

• 1 Wong ET. et al. Br J Cancer 2015; 113: 232-241
• 2 Barbarisi M. et al. Phytother Res 2019; 33: 1670-1682
• 3 Kirste S. et al. Cancer 2011; 117: 3788-3795