Zusammenfassung
Die Kombination von Radio- und Chemotherapie kann das Gesamtüberleben von Patienten mit Gliomen signifikant verbessern. Dabei stehen heute neben der lokalen Kontrolle vor allem auch die Erhaltung der Lebensqualität und der neurokognitiven Funktion im Langzeitverlauf im Vordergrund.
Literatur
Pallud J, Mandonnet E, Deroulers C, Fontaine D, Badoual M, Capelle L, Guillet-May F, Page P, Peruzzi P, Jouanneau E, Frenay M, Cartalat-Carel S, Duffau H, Taillandier L; Club de Neuro-Oncologie de la Société Française de Neurochirurgie (SFNC); Association des Neuro-Oncologues d’Expression Française (ANOCEF). Pregnancy increases the growth rates of World Health Organization grade II gliomas. Ann Neurol 2010;67:398–404.
Louis DN, Ohgaki H, Wiestler OD, et al. WHO classification of tumours of the central nervous system. Lyon: IARC, 2007.
Herrlinger U, Felsberg J, Küker W, Bornemann A, Plasswilm L, Knobbe CB et al. Gliomatosis cerebri. Molecular pathology and clinical course. Ann Neurol 2002;52:390–399.
Glas M, Bähr O, Felsberg J, Rasch K, Wiewrodt D, Schabet M, Simon M, Urbach H, Steinbach JP, Rieger J, Fimmers R, Bamberg M, Nägele T, Reifenberger G, Weller M, Herrlinger U; Neuro-Oncology Group of the German Cancer Society. NOA-05 phase 2 trial of procarbazine and lomustine therapy in gliomatosis cerebri. Ann Neurol 2011;70:445–453.
Sanson M, Cartalat-Carel S, Taillibert S, et al. Initial chemotherapy in gliomatosis cerebri. Neurology 2004;63:270–275.
Wick W, Meisner C, Hentschel B, et al. IDH1 mutations determine the prognostic versus predictive value of MGMT promoter methylation in malignant gliomas. Neurology, akzeptiert.
Weller M, Stupp R, Reifenberger G et al. MGMT promoter methylation in malignant gliomas: ready for personalized medicine? Nat Rev Neurol. 2010;6:39–51
Weller M, Stupp R, Hegi ME, et al. Personalized care in neuro-oncology coming of age: why we need MGMT and 1p/19q testing in malignant glioma patients in clinical practice. Neuro-Oncology 2012; 14: iv100–108.
Yan H, Parsons DW, Jin G, et al. IDH1 and IDH2 mutations in gliomas. N Engl J Med 2009;360:765–773
Hartmann C, Hentschel B, Wick W, et al. Patients with IDH1 wild type anaplastic astroctytomas exhibit worse prognosis than IDH1-mutated glioblastomas, and IDH1 mutation status accounts for the unfavorable prognostic effect of higher age: implications for classification of gliomas. Acta Neuropathol 2010;120:707–718.
Macdonald DR, Cascino TL, Schold SC, Jr. et al. (1990) Response criteria for phase II studies of supratentorial malignant glioma. J Clin Oncol 8:1277–1280.
Wen PY, Macdonald DR, Reardon DA et al. (2010) Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. J Clin Oncol 28:1963–1972.
Scott JN et al: How often are nonenhancing supratentorial gliomas malignant? A population study. Neurology 59:947–949, 2002
Grant R, Liang BC, Slattery J, Greenberg HS, Junck L. Chemotherapy response criteria in malignant glioma. Neurology 1997;48:1336–1340.
Prados M, Cloughesy T, Samant M, Fang L, Wen PY, Mikkelsen T, Schiff D, Abrey LE, Yung WK, Paleologos N, Nicholas MK, Jensen R, Vredenburgh J, Das A, Friedan HS. Response as a predictor of survival in patients with recurrent glioblastoma treated with bevacizumab. Neuro Oncol 2011;13:143–151.
Galanis E, Wu W, Cloughesy T, Lamborn K, Mann B, Wen PY, Reardon DA, Wick W, Macdonald D, Armstrong TS, Weller M, Vogelbaum M, Colman H, Sargent DJ, van den Bent MJ, Gilbert M, Chang S. Phase 2 trial design in neuro-oncology revisited: a report from the RANO group. Lancet Oncol 2012;13:e196–204.
Rachinger W, Goetz C, Popperl G, Gildehaus FJ, Kreth FW, Holtmannspotter M, Herms J, Koch W, Tatsch K, Tonn JC. Positron emission tomography with O-(2-[18F]fluoroethyl)-l-tyrosine versus magnetic resonance imaging in the diagnosis of recurrent gliomas. Neurosurgery 2005;57:505–511.
Kunz M, Thon N, Eigenbrod S, et al. Hot spots in dynamic (18)FET-PET delineate malignant tumor parts within suspected WHO grade II gliomas. Neuro Oncol 2011;13:307–316.
Hutterer M, Nowosielski M, Putzer D, Jansen NL, Seiz M, Schocke M, McCoy M, Göbel G, la Fougére C, Virgolini IJ, Trinka E, Jacobs AH, Stockhammer G. [18F]-fluoro-ethyl-L-tyrosine PET: a valuable diagnostic tool in neuro-oncology, but not all that glitters is glioma. Neuro Oncol 2013;15:341–351.
Stummer W, Pichlmeier U, Meinel T, et al. Fluorescence-guided surgery with 5-aminolevulinic acid for resection of malignant glioma: a randomised controlled multicentre phase III trial. Lancet Oncol 2006;7:392–401.
Stummer W, Reulen HJ, Meinel T, et al. Extent of resection and survival in glioblastoma multiforma: identification of and adjustment for bias. Neurosurgery 2008;62:564–576.
Stummer W, Nestler U, Stockhammer F, et al. Favorable outcome in the elderly cohort treated by concomitant temozolomide radiochemotherapy in a multicentric phase II safety study of 5-ALA. J Neurooncol im Druck.
Kreth FW, Thon N, Siefert A, Tonn JC. The place of interstitial brachytherapy and radiosurgery for low-grade gliomas. Adv Tech Stand Neurosurg. 2010;35:183–212.
Combs SE, Thilmann C, Edler L, et al. Efficacy of fractionated stereotactic reirradiation in recurrent gliomas: long-term results in 172 patients treated in a single institution. J Clin Oncol 2005;23:8863–8869.
Fogh SE, Andrews DW, Glass J, et al. Hypofractionated stereotactic radiation therapy: an effective therapy for recurrent high-grade gliomas. J Clin Oncol 2010;28:3048–3053.
Wick W, Debus J, Bendszus M, Kobyakov G, Martens T, Heese O, Pichler J, Combs SE, Kunz C, Fricke H. A phase II, randomized open-label, multi-center study of weekls APG101 + reirradiation versus reirradiation in the treatment of patients with recurrent glioblastoma. ESMO/ECCO Abstract 3304, 2013.
Griffin CA, Burger P, Morsberger L, et al. Identification of der(1;19)(q10;p10) in five oligodendrogliomas suggests mechanism of concurrent 1p and 19q loss. J Neuropathol Exp Neurol 2006;65:988–994
Jenkins RB, Blair H, Ballman KV, et al. A t(1;19)(q10;p10) mediates the combined deletions of 1p and 19q and predicts a better prognosis of patients with oligodendroglioma. Cancer Res 2006;66:9852–9861
Van den Bent M, Brandes AA, Taphoorn M, et al. Adjuvant procarbacine, lomustine, and vincristine chemotherapy in newly diagnosed anaplastic oligodendroglioma: long-term follow-up of EORTC Brain Tumor Group Study 26951. J Clin Oncol 2012; 31: 344–350.
Cairncross G, Wang M, Shaw E, et al. Phase III trial of chemoradiotherapy for anaplastic oligodendroglioma: long-term results of RTOG 9402. J Clin Oncol 2012; 31: 337–343.
Wick W, Hartmann C, Engel C, et al. NOA-04 randomized phase III trial of sequential radiochemotherapy of anaplastic glioma with PCV or temozolomide. J Clin Oncol 2009a;27:5874–5880.
Stupp R, Mason WP, Van Den Bent MJ et al. (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. The New England journal of medicine 352:987–996.
Hegi ME, Diserens AC, Gorlia T, et al. MGMT gene silencing and response to temozolomide in glioblastoma. N Engl J Med 2005;352:997–1003.
Wick W, Platten M, Meisner C et al. Temozolomide chemotherapy alone versus radiotherapy alone for malignant astrocytoma in the elderly: the NOA-08 randomised, phase 3 trial. Lancet Oncol. 2012 Jul;13(7):707–715.
Malmström A, Grønberg BH, Marosi C et al. Temozolomide versus standard 6-week radiotherapy versus hypofractionated radiotherapy in patients older than 60 years with glioblastoma: the Nordic randomised, phase 3 trial. Lancet Oncol. 2012 Sep;13(9):916–926.
Soffietti R et al: Guidelines on management of low-grade gliomas: report of an EFNS-EANO* task force. Eur J Neurol 17:1124–1133, 2010
Weiler M, Wick W. Molecular predictors of outcome in low-grade glioma. Current Opinion in Neurology 2012;25:767–773.
Wick W, Weller M, Weiler M, Batchelor T, Yung AWK, Platten M: Pathway inhibition: Emerging molecular targets for treating glioblastoma. Neuro Oncol 13:566–579, 2011
Weller M, Cloughesy T, Perry JR, Wick W. Standards of care for treatment of recurrent glioblastoma—are we there yet? Neuro Oncol 2013;15:4–27.
Wick W, Weller M, Van Den Bent M et al. (2010) Bevacizumab and recurrent malignant gliomas: a European perspective. J Clin Oncol 28:e188–189; author reply e190-182.
Friedman H, Prados M, Wen P, et al. Bevacizumab alone and in combination with irinotecan in recurrent glioblastoma. J Clin Oncol 2009;27:4733–4740.
Amberger-Murphy V. Hypoxia helps glioma to fight therapy. Curr Cancer Drug Targets 2009;9:381–390.
Harris AL. Hypoxia: a key regulatory factor in tumor growth. Nat Rev Cancer. 2002;2:38-
Wick W, Cloughesy TF, Nishikawa R, et al: Tumor response based on adapted Macdonald criteria and assessment of pseudoprogression (PsPD) in the phase III AVAglio trial of bevacizumab (Bv) plus temozolomide (T) plus radiotherapy (RT) in newly diagnosed glioblastoma (GBM). 2013 ASCO Annual Meeting. Abstract 2002. Presented June 1, 2013.
Roth P et al: Steroids in neurooncology: actions, indications, side-effects. Curr Opin Neurol 23:597–602, 2010
Weller M, Stupp R, Wick W. Epilepsy meets Cancer: when, why, and what to do about it? Lancet Oncol 2012;13:e375–382
Wick W, Menn O, Meisner C, et al. Pharmacotherapy of epileptic seizures in glioma patients: who, when, why and how long? Onkologie 2005;28:391–396.
Klein M, Heimans JJ, Aaronson NK, van der Ploeg HM, Grit J, Muller M, Postma TJ, Mooij JJ, Boerman RH, Beute GN, Ossenkoppele GJ, van Imhoff GW, Dekker AW, Jolles J, Slotman BJ, Struikmans H, Taphoorn MJ. Effect of radiotherapy and other treatment-related factors on mid-term to long-term cognitive sequelae in low-grade gliomas: a comparative study. Lancet. 2002;360:1361–1368.
Marras LC, Geerts WH, Perry JR. The risk of venous thromboembolism is increased throughout the course of malignant glioma. Cancer 2000;89:640–646.
Perry JR et al: PRODIGE: a randomized placebo-controlled trial of dalteparin low-molecular-weight heparin thromboprophylaxis in patients with newly diagnosed malignant glioma. J Thromb Haemost 8:1959–1965, 2008
Schmidt F, Faul C, Dichgans J, et al. Low molecular weight heparin for deep vein thrombosis in glioma patients. J Neurol 2002;249:1409–1412.
Keime-Guibert F, Chinot O, Taillandier L, et al. Radiotherapy for glioblastoma in the elderly. N Engl J Med 2007;356:1527–1535.
Roa W, Brasher PM, Bauman G, et al. Abbreviated course of radiation therapy in older patients with glioblastoma multiforme: a prospective randomized clinical trial. J Clin Oncol 2004;22:1583–1588.
Wiestler B, Claus R, Hartlieb SA et al. Malignant astrocytomas of elderly patients lack favorable molecular markers: an analysis of the NOA-08 study collective. Neuro Oncol. 2013 Apr 17. [Epub ahead of print]
Harrison, Deutsche Auflage 2012; Kapitel 379, Hirneigene Tumoren und Metastasen
Bendszus & Platten, Neuroradiologische Responsekriterien bei malignen Gliomen, Nervenarzt 2011
Pignatti F, van den Bent, Curran D, et al. Prognostic factors for survival in adult patients with cerebral low-grade glioma. J Clin Oncol 2002;20:2076–2084
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Die Autoren erklären, dass sie sich bei der Erstellung des Beitrags von keinen wirtschaftlichen Interessen leiten ließen. Prof. Wick erhält Forschungsunterstützung von Apogenix, Boehringer Ingelheim, Eli Lilly, MSD und Roche. Er hat außerdem persönliche Vortragshonorare von MSD und Roche erhalten. Er ist Mitglied des Steering Committees der AVAglio-Studie und von Advisory Boards der Formen MSD, Magforce und Roche/Genentech. Er ist außerdem Studienleiter der EORTC-26101- und 26082-Studien und der APG101 sowie Sprecher der Hirntumorgruppe der EORTC und stellvertretender Sprecher der NOA.
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Wick, W., Platten, M. Moderne Therapiestrategien bei hirneigenen glialen Tumoren. InFo Neurologie 15, 38–51 (2013). https://doi.org/10.1007/s15005-013-0305-1
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DOI: https://doi.org/10.1007/s15005-013-0305-1