Achievement of three year remission in a case of aggressive glioblastoma using a multidisciplinary treatment strategy: A case report

Ishida,Atsushi; Watanabe,Mika; Matsuo,Seigo; Niimura,Kaku; Yoshimoto,Haruko; Asakuno,Keizoh; Shiramizu,Hideki; Nemoto,Akio; Yuzawa,Miki; Hori,Tomokatsu

doi:10.3892/ol.2014.1937

Achievement of three year remission in a case of aggressive glioblastoma using a multidisciplinary treatment strategy: A case report

Authors:
- Atsushi Ishida
- Mika Watanabe
- Seigo Matsuo
- Kaku Niimura
- Haruko Yoshimoto
- Keizoh Asakuno
- Hideki Shiramizu
- Akio Nemoto
- Miki Yuzawa
- Tomokatsu Hori
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Affiliations: Department of Neurosurgery, Moriyama Memorial Hospital, Tokyo 134‑8608, Japan, Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980‑8575, Japan
Published online on: March 5, 2014 https://doi.org/10.3892/ol.2014.1937
Pages: 1608-1612

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Abstract

Glioblastoma (GB) is the most common type of malignant tumor of the central nervous system and, despite extensive research, its prognosis is poor. Although recent advances have been made in the treatment of GB with aggressive resection combined with radiochemotherapy, more than three‑quarters of GB patients succumb to the disease within two years. The current study presents a highly aggressive case of small cell GB as diagnosed by histological features and immunohistochemistry for vimentin, glial fibrillary acidic protein, oligodendrocyte lineage transcription factor 2, isocitrate dehydrogenase 1‑R132H and p53. The patient was treated using a multidisciplinary treatment strategy, which included temozolomide, CyberKnife radiotherapy and autologous formalin‑fixed tumor vaccination. In addition, the patient developed radiation necrosis, which was treated with bevacizumab. In conclusion, three years following the initial diagnosis, the patient continues to experience a successful clinical course, and the observations of the current study demonstrate that a multidisciplinary treatment strategy may be effective for the treatment of aggressive GB.

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1	Kesari S: Understanding glioblastoma tumor biology: the potential to improve current diagnosis and treatments. Semin Oncol. 38(Suppl 4): S2–S10. 2011. View Article : Google Scholar : PubMed/NCBI
2	Friedman HS, McLendon RE, Kerby T, et al: DNA mismatch repair and O6-alkylguanine-DNA alkyltransferase analysis and response to Temodal in newly diagnosed malignant glioma. J Clin Oncol. 16:3851–3857. 1998.
3	Thumma SR, Elaimy AL, Daines N, et al: Long-term survival after gamma knife radiosurgery in a case of recurrent glioblastoma multiforme: a case report and review of the literature. Case Rep Med. 2012:5454922012.
4	Villavicencio AT, Burneikiene S, Romanelli P, et al: Survival following stereotactic radiosurgery for newly diagnosed and recurrent glioblastoma multiforme: a multicenter experience. Neurosurg Rev. 32:417–424. 2009. View Article : Google Scholar
5	Okada H, Kohanbash G, Zhu X, et al: Immunotherapeutic approaches for glioma. Crit Rev Immunol. 29:1–42. 2009. View Article : Google Scholar
6	Norden AD, Young GS, Setayesh K, et al: Bevacizumab for recurrent malignant gliomas: efficacy, toxicity, and patterns of recurrence. Neurology. 70:779–787. 2008. View Article : Google Scholar : PubMed/NCBI
7	Stupp R, Mason WP, van den Bent MJ, et al: Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med. 352:987–996. 2005. View Article : Google Scholar : PubMed/NCBI
8	Park KJ, Kano H, Iyer A, et al: Salvage gamma knife stereotactic radiosurgery followed by bevacizumab for recurrent glioblastoma multiforme: a case-control study. J Neurooncol. 107:323–333. 2012. View Article : Google Scholar
9	Conti A, Pontoriero A, Arpa D, et al: Efficacy and toxicity of CyberKnife re-irradiation and ‘dose dense’ temozolomide for recurrent gliomas. Acta Neurochir (Wien). 154:203–209. 2012.
10	Cabrera AR, Cuneo KC, Vredenburgh JJ, Sampson JH and Kirkpatrick JP: Stereotactic radiosurgery and bevacizumab for recurrent glioblastoma multiforme. J Natl Compr Canc Netw. 10:695–699. 2012.PubMed/NCBI
11	Ohno T: Autologous formalin-fixed tumor vaccine. Curr Pharm Des. 11:1181–1188. 2005. View Article : Google Scholar : PubMed/NCBI
12	Midgley R and Kerr D: Bevacizumab--current status and future directions. Ann Oncol. 16:999–1004. 2005. View Article : Google Scholar : PubMed/NCBI
13	Rahman M and Hoh BL: Avastin in the treatment for radiation necrosis: exciting results from a recent randomized trial. World Neurosurg. 75:4–5. 2011. View Article : Google Scholar : PubMed/NCBI
14	Wong ET, Huberman M, Lu XQ and Mahadevan A: Bevacizumab reverses cerebral radiation necrosis. Euro J Med Res. 26:5649–5650. 2008.PubMed/NCBI
15	Furuse M, Kawabata S, Kuroiwa T and Miyatake S: Repeated treatments with bevacizumab for recurrent radiation necrosis in patients with malignant brain tumors: a report of 2 cases. J Neurooncol. 102:471–475. 2011. View Article : Google Scholar : PubMed/NCBI
16	Kato T, Shinoda J, Nakayama N, et al: Metabolic assessment of gliomas using 11C-methionine, [18F] fluorodeoxyglucose, and 11C-choline positron-emission tomography. AJNR Am J Neuroradiol. 29:1176–1182. 2008.
17	Louis DN, Ohgaki H, Wiestler OD, et al: The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 114:97–109. 2007. View Article : Google Scholar : PubMed/NCBI
18	Daumas-Duport C, Scheithauer B, O’Fallon J and Kelly P: Grading of astrocytomas. A simple and reproducible method. Cancer. 62:2152–2165. 1988. View Article : Google Scholar : PubMed/NCBI
19	Muragaki Y, Maruyama T, Iseki H, et al: Phase I/IIa trial of autologous formalin-fixed tumor vaccine concomitant with fractionated radiotherapy for newly diagnosed glioblastoma. Clinical article. J Neurosurg. 115:248–255. 2011. View Article : Google Scholar
20	Brat DJ, Parisi JE, Kleinschmidt-DeMasters BK, et al: Surgical neuropathology update: a review of changes introduced by the WHO classification of tumours of the central nervous system, 4th edition. Arch Pathol Lab Med. 132:993–1007. 2008.
21	Burger PC, Pearl DK, Aldape K, et al: Small cell architecture - a histological equivalent of EGFR amplification in glioblastoma multiforme? J Neuropathol Exp Neurol. 60:1099–1104. 2001.
22	Yan H, Parsons DW, Jin G, et al: IDH1 and IDH2 mutations in gliomas. N Engl J Med. 360:765–773. 2009. View Article : Google Scholar : PubMed/NCBI
23	Ohgaki H and Kleihues P: Genetic profile of astrocytic and oligodendroglial gliomas. Brain Tumor Pathol. 28:177–183. 2011. View Article : Google Scholar : PubMed/NCBI
24	Oermann E, Collins BT, Erickson KT, et al: CyberKnife enhanced conventionally fractionated chemoradiation for high grade glioma in close proximity to critical structures. J Hematol Oncol. 3:222010. View Article : Google Scholar
25	Flechl B, Ackerl M, Sax C, et al: Neurocognitive and sociodemographic functioning of glioblastoma long-term survivors. J Neurooncol. 109:331–339. 2012. View Article : Google Scholar