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Case report: Radiographic complete response of radiation-induced glioblastoma to front-line radiotherapy: A report and molecular characterization of two unique cases

Radiation-induced gliomas (RIGs) are an uncommon disease type and a known long-term complication of prior central nervous system radiation exposure, often during childhood. Given the rarity of this malignancy subtype, no clinical trials have explored optimal therapy for these patients, and the liter...

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Autores principales: Grogan, Patrick T., Helgager, Jeffrey J., Deming, Dustin A., Howard, Steven P., Jenkins, Robert B., Robins, H. Ian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10070702/
https://www.ncbi.nlm.nih.gov/pubmed/37025206
http://dx.doi.org/10.3389/fneur.2023.1099424
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author Grogan, Patrick T.
Helgager, Jeffrey J.
Deming, Dustin A.
Howard, Steven P.
Jenkins, Robert B.
Robins, H. Ian
author_facet Grogan, Patrick T.
Helgager, Jeffrey J.
Deming, Dustin A.
Howard, Steven P.
Jenkins, Robert B.
Robins, H. Ian
author_sort Grogan, Patrick T.
collection PubMed
description Radiation-induced gliomas (RIGs) are an uncommon disease type and a known long-term complication of prior central nervous system radiation exposure, often during childhood. Given the rarity of this malignancy subtype, no clinical trials have explored optimal therapy for these patients, and the literature is primarily limited to reports of patient cases and series. Indeed, the genomic profiles of RIGs have only recently been explored in limited numbers, categorizing these gliomas into a unique subset. Here, we describe two cases of RIG diagnosed as glioblastoma (GB), IDH-wildtype, in adults who had previously received central nervous system radiation for childhood cancers. Both patients demonstrated a surprising complete radiographic response of the postoperative residual disease to front-line therapy, a phenomenon rarely observed in the management of any GB and never previously reported for the radiation-induced subgroup. Both tumors were characterized by next-generation sequencing and chromosomal microarray to identify potential etiologies for this response as well as to further add to the limited literature about the unique molecular profile of RIGs, showing signatures more consistent with diffuse pediatric-type high-grade glioma, H3-wildtype, and IDH-wildtype, WHO grade 4. Ultimately, we demonstrate that treatment utilizing a radiation-based regimen for GB in a previously radiated tissue can be highly successful despite historical limitations in the management of this disease.
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spelling pubmed-100707022023-04-05 Case report: Radiographic complete response of radiation-induced glioblastoma to front-line radiotherapy: A report and molecular characterization of two unique cases Grogan, Patrick T. Helgager, Jeffrey J. Deming, Dustin A. Howard, Steven P. Jenkins, Robert B. Robins, H. Ian Front Neurol Neurology Radiation-induced gliomas (RIGs) are an uncommon disease type and a known long-term complication of prior central nervous system radiation exposure, often during childhood. Given the rarity of this malignancy subtype, no clinical trials have explored optimal therapy for these patients, and the literature is primarily limited to reports of patient cases and series. Indeed, the genomic profiles of RIGs have only recently been explored in limited numbers, categorizing these gliomas into a unique subset. Here, we describe two cases of RIG diagnosed as glioblastoma (GB), IDH-wildtype, in adults who had previously received central nervous system radiation for childhood cancers. Both patients demonstrated a surprising complete radiographic response of the postoperative residual disease to front-line therapy, a phenomenon rarely observed in the management of any GB and never previously reported for the radiation-induced subgroup. Both tumors were characterized by next-generation sequencing and chromosomal microarray to identify potential etiologies for this response as well as to further add to the limited literature about the unique molecular profile of RIGs, showing signatures more consistent with diffuse pediatric-type high-grade glioma, H3-wildtype, and IDH-wildtype, WHO grade 4. Ultimately, we demonstrate that treatment utilizing a radiation-based regimen for GB in a previously radiated tissue can be highly successful despite historical limitations in the management of this disease. Frontiers Media S.A. 2023-03-21 /pmc/articles/PMC10070702/ /pubmed/37025206 http://dx.doi.org/10.3389/fneur.2023.1099424 Text en Copyright © 2023 Grogan, Helgager, Deming, Howard, Jenkins and Robins. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Grogan, Patrick T.
Helgager, Jeffrey J.
Deming, Dustin A.
Howard, Steven P.
Jenkins, Robert B.
Robins, H. Ian
Case report: Radiographic complete response of radiation-induced glioblastoma to front-line radiotherapy: A report and molecular characterization of two unique cases
title Case report: Radiographic complete response of radiation-induced glioblastoma to front-line radiotherapy: A report and molecular characterization of two unique cases
title_full Case report: Radiographic complete response of radiation-induced glioblastoma to front-line radiotherapy: A report and molecular characterization of two unique cases
title_fullStr Case report: Radiographic complete response of radiation-induced glioblastoma to front-line radiotherapy: A report and molecular characterization of two unique cases
title_full_unstemmed Case report: Radiographic complete response of radiation-induced glioblastoma to front-line radiotherapy: A report and molecular characterization of two unique cases
title_short Case report: Radiographic complete response of radiation-induced glioblastoma to front-line radiotherapy: A report and molecular characterization of two unique cases
title_sort case report: radiographic complete response of radiation-induced glioblastoma to front-line radiotherapy: a report and molecular characterization of two unique cases
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10070702/
https://www.ncbi.nlm.nih.gov/pubmed/37025206
http://dx.doi.org/10.3389/fneur.2023.1099424
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