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Clinical Findings of Thalamic and Brainstem Glioma Including Diffuse Midline Glioma, H3K27M Mutant:A Clinical Study Yongson KIM 1 , Takumi KUDO 1 , Kaoru TAMURA 1 , Kazutaka SUMITA 2 , Daisuke KOBAYASHI 3 , Yoji TANAKA 1 , Motoki INAJI 1 , Tadashi NARIAI 1 , Kenji ISHII 4 , Taketoshi MAEHARA 1 1Department of Neurosurgery, Tokyo Medical and Dental University 2Department of Endovascular Surgery, Tokyo Medical and Dental University 3Department of Human Pathology, Tokyo Medical and Dental University 4Research Team for Neuroimaging, Tokyo Metropolitan Institute of Gerontology Keyword: glioma , H3K27M mutation , thalamus , brainstem pp.901-908
Published Date 2021/7/10
DOI https://doi.org/10.11477/mf.1436204469
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 BACKGROUND:Diffuse midline glioma, H3K27M mutant is a glioma located in the thalamus, brainstem, or spine with the H3K27M mutation, which is a new entity in the 2016 revised WHO classification. The treatment of thalamic glioma(TG)and brainstem glioma(BSG), which includes diffuse midline gliomas, the H3K27M mutant is challenging, and there are no standard therapeutic strategies. It is important to determine the characteristics of these brain tumors. Here, we retrospectively reviewed 31 consecutive patients with TG and BSG who were treated at our institute between January 1994 and May 2018, including methionine-positron emission tomography(MET-PET)data.

 RESULTS: Fourteen patients had TG, while 17 patients had BSG. Six patients were children, and 25 were adults. Nine patients with TGs and seven with BSG were enhanced by gadolinium. Twenty-seven patients were treated with radiotherapy, and 20 patients were treated with chemotherapy. All 21 tumors that underwent surgery showed wild-type IDH. The H3K27M mutation was present in four TG and two BSG. There was no statistically significant association between methionine uptake and gadolinium contrast enhancement and tumor grade. The median overall survival period(OS)of all cases was 16.9 months, whereas those of TG and BSG were 22.8 and 10.0 months, respectively.

 CONCLUSION:Because TG and BSG still have poor prognoses, it is necessary to elucidate the pathology of the disease and establish its standard therapy.


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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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