Document Type
Article
Publication Date
12-1-2023
Abstract
Background: Gliomatosis cerebri (GC) is a rare and aggressive form of widely disseminated glioma infiltrating at least 3 lobes of the brain. It is a diffuse pattern of growth seen in glioma rather than a distinct pathological diagnosis based on new Word Health Organization (WHO) classification. Despite this, it is associated with worse prognosis than equally graded gliomas. Tumor treating fields (TTFields) treatment is a more recent advancement in glioma treatment delivered through low energy, intermediate frequency (200 kHz) electromagnetic fields, with multi-modal mechanisms of action. It is Food and Drug Administration (FDA) approved for newly diagnosed and recurrent glioblastoma (GBM). The aim of this case report is to present a durable response of GBM associated GC to concurrent TTFields with chemoradiation.
Case Description: We report a 64-year-old male with left parietal GBM, IDH wild type, WHO grade 4 with extensive GC change. After resection of the enhancing lesion, the patient received concurrent tumor-treating fields (TTFields) with radiation and temozolomide, enrolled in SPARE trial (NCT03477110). The patient had a rapid response in the areas of gliomatosis change demonstrated on the magnetic resonance imaging 1 month post-radiation treatment. The response of GC was durable. His glioma recurred 11 months after surgery with new enhancing lesions, treated with radiosurgery. He had further extensive progression of enhancing lesions 13 months after surgery, and received bevacizumab treatment. The patient ultimately passed away 17 months after surgery. Despite progression of enhancing lesions, the GC changes remained controlled. He also had favorable progression-free survival of 11 months and overall survival of 17 months.
Conclusions: This case serves as an example of how combination TTFields with chemoradiation may elicit a durable response of GC in patients with GBM.
Recommended Citation
DesJarlais, Alex M.; Miller, Ryan C.; Ali, Ayesha S.; Niazi, Muneeb Z.; Cappelli, Louis; Glass, Jon; Farrell, Christopher J.; and Shi, Wenyin, "Case Report: Durable Response of Gliomatosis Cerebri With Concurrent Tumor-Treating Fields (Ttfields) and Chemoradiotherapy Treatment" (2023). Department of Radiation Oncology Faculty Papers. Paper 197.
https://jdc.jefferson.edu/radoncfp/197
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
PubMed ID
38195076
Language
English
Comments
This article is the author's final published version in Chinese Clinical Oncology, Volume 12, Issue 6, 31 December 2023, Article number 69.
The published version is available at https://doi.org/10.21037/cco-23-114. Copyright © Chinese Clinical Oncology. All rights reserved.