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...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1099424/full |
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| author | Patrick T. Grogan Patrick T. Grogan Patrick T. Grogan Jeffrey J. Helgager Dustin A. Deming Dustin A. Deming Dustin A. Deming Steven P. Howard Steven P. Howard Robert B. Jenkins H. Ian Robins H. Ian Robins H. Ian Robins H. Ian Robins |
| author_facet | Patrick T. Grogan Patrick T. Grogan Patrick T. Grogan Jeffrey J. Helgager Dustin A. Deming Dustin A. Deming Dustin A. Deming Steven P. Howard Steven P. Howard Robert B. Jenkins H. Ian Robins H. Ian Robins H. Ian Robins H. Ian Robins |
| author_sort | Patrick T. Grogan |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-04-09T23:32:28Z |
| format | Article |
| id | doaj.art-fd5e022e89164767842b930277235940 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-09T23:32:28Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-fd5e022e89164767842b9302772359402023-03-21T05:04:05ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-03-011410.3389/fneur.2023.10994241099424Case report: Radiographic complete response of radiation-induced glioblastoma to front-line radiotherapy: A report and molecular characterization of two unique casesPatrick T. Grogan0Patrick T. Grogan1Patrick T. Grogan2Jeffrey J. Helgager3Dustin A. Deming4Dustin A. Deming5Dustin A. Deming6Steven P. Howard7Steven P. Howard8Robert B. Jenkins9H. Ian Robins10H. Ian Robins11H. Ian Robins12H. Ian Robins13Department of Medicine, Division of Hematology, Medical Oncology, and Palliative Care, University of Wisconsin, Madison, WI, United StatesMcArdle Laboratory for Cancer Research, Department of Oncology, University of Wisconsin, Madison, WI, United StatesCarbone Comprehensive Cancer Center, University of Wisconsin, Madison, WI, United StatesDepartment of Pathology and Laboratory Medicine, University of Wisconsin, Madison, WI, United StatesDepartment of Medicine, Division of Hematology, Medical Oncology, and Palliative Care, University of Wisconsin, Madison, WI, United StatesMcArdle Laboratory for Cancer Research, Department of Oncology, University of Wisconsin, Madison, WI, United StatesCarbone Comprehensive Cancer Center, University of Wisconsin, Madison, WI, United StatesCarbone Comprehensive Cancer Center, University of Wisconsin, Madison, WI, United StatesDepartment of Human Oncology, University of Wisconsin, Madison, WI, United StatesDepartment of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United StatesDepartment of Medicine, Division of Hematology, Medical Oncology, and Palliative Care, University of Wisconsin, Madison, WI, United StatesCarbone Comprehensive Cancer Center, University of Wisconsin, Madison, WI, United StatesDepartment of Human Oncology, University of Wisconsin, Madison, WI, United StatesDepartment of Neurology, University of Wisconsin, Madison, WI, United StatesRadiation-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.https://www.frontiersin.org/articles/10.3389/fneur.2023.1099424/fullradiation-induced glioma (RIG)complete response (CR)radiationmolecular sequencingchromosomal microarray |
| spellingShingle | Patrick T. Grogan Patrick T. Grogan Patrick T. Grogan Jeffrey J. Helgager Dustin A. Deming Dustin A. Deming Dustin A. Deming Steven P. Howard Steven P. Howard Robert B. Jenkins H. Ian Robins H. Ian Robins H. Ian Robins H. Ian Robins Case report: Radiographic complete response of radiation-induced glioblastoma to front-line radiotherapy: A report and molecular characterization of two unique cases Frontiers in Neurology radiation-induced glioma (RIG) complete response (CR) radiation molecular sequencing chromosomal microarray |
| 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 | radiation-induced glioma (RIG) complete response (CR) radiation molecular sequencing chromosomal microarray |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1099424/full |
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