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Current State of Art of the Therapy of WHO Grade III Gliomas in the Czech Republic


Authors: O. Kalita 1;  F. Kramář 2;  E. Neumann 3;  T. Hrbáč 4;  M. Bolcha 5;  R. Brabec 6;  R. Jančálek 7;  D. Štěpánek 8;  M. Bláha 9;  P. Jurek 10;  D. Malúšková 11;  J. Strenková 11
Authors‘ workplace: Neurochirurgická klinika LF UP a FN Olomouc 1;  Neurochirurgická klinika 1. LF UK a ÚVN Praha 2;  Neurochirurgická klinika LF MU a FN Brno 3;  Neurochirurgická klinika LF OU a FN Ostrava 4;  Neurochirurgická klinika UJEP a Krajská zdravotní a. s., Masarykova nemocnice v Ústí nad Labem, o. z. 5;  Neurochirurgické oddělení, Krajská nemocnice Liberec, a. s. 6;  Neurochirurgická klinika LF MU a FN U sv. Anny v Brně 7;  Neurochirurgické oddělení, FN Plzeň 8;  Neurochirurgická klinika 2. LF UK a FN v Motole, Praha 9;  Neurochirurgické oddělení, Krajská nemocnice T. Bati, a. s., Zlín 10;  Institut biostatistiky a analýz, LF MU, Brno 11
Published in: Cesk Slov Neurol N 2015; 78/111(3): 306-316
Category: Original Paper

Overview

The aim of our paper is to evaluate treatment results for WHO grade III gliomas in the Czech Republic. We performed an assessment of a sample of patients from the glioma tumor DoIT registry. Data on 226 patients dia­gnosed with WHO grade III gliomas between 1 January 2007 and 31 December 2012 in ten centers were available for statistical analysis. We failed to prove an effect of gender on overall survival. However, a positive effect of patient age, oligodendroglial tumor component (median survival – 45.3 months), extent of resection (median survival – 25.4 months), chemoradiotherapy vs. radiotherapy alone (median survival – 33.1 vs. 11.6 months) was shown as well as a synergic effect of total tumor resection plus chemoradiotherapy on overall survival (median survival – 36 months). Temozolomide was the first‑choice chemotherapy regimen in all centers; PCV chemotherapy was initially administered in one case of oligo‑glioma only. The analysis also implies that implementation of cytogenetic investigation of prognostic markers (MGMT, 1p/19q, IDH, ATRX) into standard laboratory procedures is required if individualized therapy of WHO grade III glioma is to take place. WHO grade III gliomas are a very heterogeneous group of tumors with different prognosis and treatment response. Virtually all comprehensive cancer centers have appointed neuro‑oncologic teams including neurologists and neurosurgeons who thus participate in establishing the general management strategy for WHO grade III gliomas.

Key words:
anaplastic gliomas – general management strategy – radical resection – chemoradiotherapy

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.


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Paediatric neurology Neurosurgery Neurology

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Czech and Slovak Neurology and Neurosurgery

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