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Characteristics and therapeutic strategies of radiation-induced glioma: case series and comprehensive literature review

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Abstract

Introduction

The so-called radiation-induced glioma (RIG, a secondary glioma after cranial irradiation), is a serious late effect after cranial radiation therapy. The clinical characteristics of and ideal treatment for these tumors are unclear. We analyzed our case series and conducted a comprehensive literature review to reveal the precise characteristics of RIGs.

Methods

We analyzed the cases of six patients with RIGs treated at our institution and 354 patients with RIGs from the literature. The latency period from irradiation to the development of each RIG and the median overall survival of the patients were subjected to Kaplan–Meier analyses. Spearman’s correlation test was used to determine the relationship between age at irradiation and the latency period.

Results

The mean age of the 360 patients at the development of RIG was 27.42 ± 17.87 years. The mean latency period was 11.35 ± 8.58 years. Multiple gliomas were observed in 28.4%. WHO grade 3 and 4 RIGs accounted for 93.3%. The latency periods were significant shorter in the higher WHO grade group (p = 0.0366) and the concomitant systemic chemotherapy group (p < 0.0001). Age at irradiation was negatively associated with the latency period (r =− 0.2287, p = 0.0219). The patients treated with radiotherapy achieved significantly longer survival compared to those treated without radiotherapy (p = 0.0011).

Conclusions

Development in younger age, multiplicity, and high incidence of grade 3 and 4 are the clinical characteristics of RIGs. Cranial irradiation at older ages and concomitant chemotherapy were associated with shorter latency for the development of RIG. Radiation therapy may be the feasible treatment option despite radiation-induced gliomas.

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Funding

The authors declare that no funds, grants, or other support were received for the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan

    Shumpei Onishi, Fumiyuki Yamasaki, Takeshi Takayasu, Ushio Yonezawa, Akira Taguchi & Nobutaka Horie

  2. Department of Neurosurgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, 3-1 Aoyama-cho, Kure City, Hiroshima, 737-0023, Japan

    Shumpei Onishi & Shinji Ohba

  3. Department of Pathology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan

    Vishwa Jeet Amatya & Yukio Takeshima

  4. Department of Clinical Oncology and Neuro-oncology Program, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan

    Kazuhiko Sugiyama

Authors
  1. Shumpei Onishi
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  2. Fumiyuki Yamasaki
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  9. Nobutaka Horie
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  10. Kazuhiko Sugiyama
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Contributions

All authors contributed to the study conception and design. The material preparation and the data collection and analyses were performed by SO and FY. The first draft of the manuscript was written by SO, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Shumpei Onishi.

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Onishi, S., Yamasaki, F., Amatya, V.J. et al. Characteristics and therapeutic strategies of radiation-induced glioma: case series and comprehensive literature review. J Neurooncol 159, 531–538 (2022). https://doi.org/10.1007/s11060-022-04090-9

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  • DOI: https://doi.org/10.1007/s11060-022-04090-9

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