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CC BY-NC-ND 4.0 · South Asian J Cancer 2015; 04(01): 015-017
DOI: 10.4103/2278-330X.149931
NEURO-ONCOLOGY : Original Article

Impact of changing trends of treatment on outcome of cerebral gliosarcoma: A tertiary care centre experience

Autor*innen

  • Kumar Narendra

    Department of Radiation Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh

  • Tapesh Bhattacharyya

    Department of Radiation Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh

  • Chanchalani Karan

    Department of Radiation Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh

  • Praveen Shalunke

    Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh

  • B D Radotra

    Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh

  • Budhi Singh Yadav

    Department of Radiation Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh

Source of Support: Nill.
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Abstract

Aim: To assess clinicopathological features and outcomes in patients of primary gliosarcoma with changing trends of treatment. Materials and Methods: Medical records were reviewed and data collected on primary gliosarcoma over a 5-year period (2009–2013) from the departmental case files. Results: A total 27 patients were included in this study. The median age of presentation was 54 years. There was a slight male preponderance, with male to female ratio of 1.25:1. The most common location of the tumor was temporal lobe (44.4%). Gross total resection was possible in 19 cases, near total excision was done in five cases, and only partial excision with decompression in three cases. Of the 27 patients, 80.8% patients received post-operative radical external beam radiotherapy of 60 Gy/30#/6 weeks. Concurrent and adjuvant temozolomide was used in 42.3% cases, depending on affordability and tolerance. Median overall survival was 9 months. On subgroup analysis, median overall survival in the radiotherapy plus temozolomide group was 10 months as compared to 9 months in the radiotherapy alone group; however, this was not statistically significant.(P = 0.244). Conclusion: Treating Gliosarcoma is a major therapeutic challenge for a clinician because of its poor prognosis, aggressive clinical behavior, rarity, and limited clinical experience. With surgery and concurrent chemoradiation, we were able to achieve a median overall survival of 9 months. Addition of temozolomide has shown a better trend in survival though it is not statistically significant.

Key words

Gliosarcoma - radiotherapy - temozolomide


Publikationsverlauf

Artikel online veröffentlicht:
31. Dezember 2020

© 2015. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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  • 1 Lutterbach J, Guttenberger R, Pagenstecher A. Gliosarcoma: A clinical study. Radiother Oncol 2001;61:57-64.
  • 2 Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, et al. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 2007;114:97-109.
  • 3 Stroebe H.  Ueber Entstehung und Bau der Gehirnglioma. Beitr Pathol Anat Allg Pathol 1895;19:405-86.
  • 4 Reis RM, Konu-Lebleblicioglu D, Lopes JM, Kleihues P, Ohgaki H. Genetic profile of gliosarcomas. Am J Pathol 2000;156:425-32.
  • 5 Boerman RH, Anderl K, Herath J, Borell T, Johnson N, Schaeffer-Klein J, et al. The glial and mesenchymal elements of gliosarcomas share similar genetic alterations. J Neuropathol Exp Neurol 1996;55:973-81.
  • 6 di Norcia V, Piccirilli M, Giangaspero F, Salvati M. Gliosarcomas in the elderly: Analysis of 7 cases and clinico-pathological remarks. Tumori 2008;94:493-6.
  • 7 Han SJ, Yang I, Tihan J, Prados MD, Parsa AT. Primary gliosarcoma: Key clinical and pathologic distinctions from glioblastoma with implications as a unique oncologic entity. J Neurooncol 2010;96:313-20.
  • 8 Galanis E, Buckner JC, Dinapoli RP, Scheithauer BW, Jenkins RB, Wang CH, et al. Clinical outcome of gliosarcoma compared with glioblastoma multiforme: North Central Cancer Treatment Group results. J Neurosurg 1998;89:425-30.
  • 9 Ehrenreich T, Devlin JF. A complex of glioblastoma and spindle-cell sarcoma with pulmonary metastases. AMA Arch Pathol 1958;66:536-49.
  • 10 Smith D, Hardman JM, Earle KM. Glioblastoma multiforme and fibrosarcoma with extracranial metastasis. Cancer 1969;24:270-6.
  • 11 Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJ, et al., European Organisation for Research and Treatment of Cancer Brain Tumor and Radiotherapy Groups, National Cancer Institute of Canada Clinical Trials Group. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 2005;352:987-96.
  • 12 Perry JR, Ang LC, Bilbao JM, Muller PJ. Clinicopathologic features of primary and postirradiation cerebral gliosarcoma. Cancer 1995;75:2910-8.
  • 13 Biswas A, Kumar N, Kumar P, Vasistha RK, Gupta K, Sharma SC, et al. Primary Gliosarcoma--clinical experience from a regional cancer centre in North India. Br J Neurosurg 2011;25:723-9.
  • 14 Morantz R, Feigin I, Ransohoff J 3 rd . Clinical and pathological study of 24 cases of gliosarcoma. J Neurosurg 1976;45:398-408.
  • 15 Meis J, Martz KL, Nelson JS. Mixed glioblastoma multiforme and sarcoma. A clinicopathologic study of 26 radiation therapy oncology group cases. Cancer 1990;67:2342-9.
  • 16 Miller CR, Perry A. Glioblastoma: Morphologic and molecular genetic diversity. Arch Pathol Lab Med 2007;131:397-406.
  • 17 Maiuri F, Stella L, Benvenuti D, Giamundo A, Pettinato G. Cerebral gliosarcomas: Correlation of computed tomographic findings, surgical aspect, pathological features, and prognosis. Neurosurgery 1990;26:261-2.
  • 18 Prados MD, Chang SM, Butowski N, DeBoer R, Parvataneni R, Carliner H, et al. Phase II study of erlotinib plus temozolomide during and after radiation therapy in patients with newly diagnosed glioblastoma multiforme or gliosarcoma. J Clin Oncol 2009;27:579-84.