1. Long-term survival in glioblastoma : methyl guanine methyl transferase (MGMT) promoter methylation as independent favourable prognostic factorUroš Smrdel, Mara Popović, Matjaž Zwitter, Emanuela Boštjančič, Andrej Zupan, Viljem Kovač, Damjan Glavač, Drago Bokal, Janja Jerebic, 2016, original scientific article Abstract: In spite of significant improvement after multi-modality treatment, prognosis of most patients with glioblastoma remains poor. Standard clinical prognostic factors (age, gender, extent of surgery and performance status) do not clearly predict long-term survival. The aim of this case-control study was to evaluate immuno-histochemical and genetic characteristics of the tumour as additional prognostic factors in glioblastoma. Long-term survivor group were 40 patients with glioblastoma with survival longer than 30 months. Control group were 40 patients with shorter survival and matched to the long-term survivor group according to the clinical prognostic factors. All patients underwent multimodality treatment with surgery, postoperative conformal radiotherapy and temozolomide during and after radiotherapy. Biopsy samples were tested for the methylation of MGMT promoter (with methylation specific polymerase chain reaction), IDH1 (with immunohistochemistry), IDH2, CDKN2A and CDKN2B (with multiplex ligation-dependent probe amplification), and 1p and 19q mutations (with fluorescent in situ hybridization). Methylation of MGMT promoter was found in 95% and in 36% in the long-term survivor and control groups, respectively (p < 0.001). IDH1 R132H mutated patients had a non-significant lower risk of dying from glioblastoma (p= 0.437), in comparison to patients without this mutation. Other mutations were rare, with no significant difference between the two groups. Molecular and genetic testing offers additional prognostic and predictive information for patients with glioblastoma. The most important finding of our analysis is that in the absence of MGMT promoter methylation, longterm survival is very rare. For patients without this mutation, alternative treatments should be explored.
Keywords: glioblastoma, long-term survival, methyl guanine methyl transferase, MGMT, prognostic factor
Published in DiRROS: 30.04.2024; Views: 87; Downloads: 77
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2. Glioblastoma patients in Slovenia from 1997 to 2008Uroš Smrdel, Viljem Kovač, Mara Popović, Matjaž Zwitter, 2014, original scientific article Abstract: Glioblastoma is the most common primary brain tumour. It has a poor prognosis despite some advances in treatment that have been achieved over the last ten years. In Slovenia, 50 to 60 glioblastoma patients are diagnosed each year. In order to establish whether the current treatment options have any influence on the survival of the Slovenian glioblastoma patients, their data in the period from the beginning of the year 1997 to the end of the year 2008 have been analysed. Patients and methods. All patients treated at the Institute of Oncology Ljubljana from 1997 to 2008 were included in the retrospective study. Demographics, treatment details, and survival time after the diagnosis were collected and statistically analysed for the group as a whole and for subgroups. Results. From 1997 to 2008, 527 adult patients were diagnosed with glioblastoma and referred to the Institute of Oncology for further treatment. Their median age was 59 years (from 20 to 85) and all but one had the diagnosis confirmed by a pathologist. Gross total resection was reported by surgeons in 261 (49.5%) patients; good functional status (WHO 0 or 1) after surgery was observed in 336 (63.7%) patients, radiotherapy was performed in 422 (80.1%) patients, in 317 (75.1%) of them with radical intent, and 198 (62.5 %) of those received some form of systemic treatment (usually temozolomide). The median survival of all patients amounted to 9.7 months. There was no difference in median survival of all patients or of all treated patients before or after the chemo-radiotherapy era. However, the overall survival of patients treated with radical intent was significantly better (11.4 months; p < 0.05). A better survival was also noticed in radically treated patients who received additional temozolomide therapy (11.4 vs. 13.1 months; p = 0.014). The longer survival was associated with a younger age and a good performance status as well as with a more extensive tumour resection. In patients treated with radical intent, having a good performance status, and receiving radiotherapy and additional temozolomide therapy, the survival was significantly longer, based on multivariate analysis.
Keywords: glioblastoma, treatment, survival, surgery, radiotherapy, termozolomide
Published in DiRROS: 11.04.2024; Views: 305; Downloads: 371
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3. Genetic markers in oligodendroglial tumoursTomaž Velnar, Uroš Smrdel, Mara Popović, Gorazd Bunc, 2010, review article Abstract: Background. Oliogodendrogliomas are brain tumours composed of the cells resembling oligodendrocytes. They represent the third most common glial tumour, comprising 2.5% of all primary brain tumours and 5-20% of all gliomas. Conclusions. Oligodendroglial tumours with 1p and 19q loss demonstrate a better overall prognosis due to more indolent clinical behaviour and higher sensitivity to treatment. Additionally, 1p and 19q loss is a marker of clinical utility, helping to assess tumour sensitivity to chemotherapy and harbouring the potential for improving the diagnosis and survival of oligodendroglioma patients as well as future clinical practice.
Published in DiRROS: 15.03.2024; Views: 124; Downloads: 32
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6. Progresivna multifokalna levkoencefalopatija po rituksimabu pri bolniku z recidivnim limfomom plaščnih celic v popolni remisijiTanja Roš-Opaškar, Matej Horvat, Mara Popović, Barbara Jezeršek Novaković, 2012, original scientific article Abstract: Progresivna multifokalna levkoencefalopatija (PML) je redko in običajno smrtno demielinizacijsko obolenje možganov, ki se razvije skoraj izključno pri bolnikih z imunsko pomanjkljivostjo in je posledica reaktivacije latentne okužbe s polioma virusom JC. V zadnjih letih so opisani tudi primeri PML po zdravljenju z rituksimabom. Predstavljamo naš prvi potrjeni primer PML pri 55-letnem HIV-negativnem bolniku z recidivnim limfomom plaščnih celic, pri katerem smo raka uspešno zdravili s kemoterapijo in rituksimabom ter z avtologno presaditvijo perifernih krvotvornih matičnih celic (PKMC). S primerom želimo opozoriti na pomembnost PML v diferencialni diagnozi pri bolnikih z napredujočo nevrološko simptomatiko in imunsko pomanjkljivostjo po zdravljenju limfoma z rituksimabom ter pomembnost zgodnjega prepoznavanja te bolezni z dokazom JC-virusne okužbe v likvorju ali v vzorcu stereotaktične biopsije možganov.
Published in DiRROS: 31.08.2018; Views: 3302; Downloads: 814
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