Role of hypoxia on invasion of glioblastoma multiforme / 中国综合临床

Glioblastoma multiforme (GBM) is the most aggressive grade IV astrocytoma which is the common type of malignant (cancerous) primary brain tumor.The median survival time was 15-17 months.At present, the conventional treatment methods of GBM are surgical resection, radiotherapy and temozolomide chemotherapy of Temozolomide.The invasiveness of tumor is not only the main obstacle of surgery, radiotherapy and chemotherapy, but also the main cause of death of GBM patients.GBM patients will gradually develop resistance to chemotherapy, leading to tumor regrowth or recurrence, but the exact mechanism is not very clear.In recent years, the role of hypoxia in tumor metastasis and invasion has been paid more and more attention.Understanding how hypoxia induces GBM cell invasiveness is particularly important for developing new and more effective therapies to combat this catastrophic disease.It is believed that hypoxia can increase the invasiveness of GBM by inducing degradation and remodeling of extracellular matrix, expression of tissue factors, promoting epithelial mesenchymal transition and angiogenesis, and regulating GBM ion channels.

Pre-operative clinical factors predict progression-free survival and tumor recurrence after initial surgery in patients with astrocytomas: a single-center analysis

Pre-operative predictive factors of progression-free survival [PFS] and tumor recurrence after initial surgery are important in counseling patients and decision making. Though PFS after initial surgery in patients with low grade astrocytomas has been described, little is described about PFS in patients with different tumor grades. Our objective was to investigate potential predictive factors of PFS, and devise a scale to predict PFS and tumor recurrence after initial surgery in patients with primary and recurrent astrocytomas of low and high tumor grades. Clinical, radiographic, pathological and treatment data of 62 patients whose initial treatments of primary and recurrent astrocytomas were both surgeries were analyzed, and factors that had significant correlation with PFS was used to devise a scale. Factors significantly related with PFS were: the time from onset of symptoms to clinical and radiological diagnosis of astrocytomas [Spearman correlation coefficient r=0.298, significance level P=0.019] and with the symptoms of seizures [r=0.292, P=0.021]. Patients with age between 30 and 40 years had significant longer PFS than the rest age group [P=0.018, oneway ANOVA]. A simple scale [from 0 to 3 points] comprised of the three factors distinguished four groups of patients with significant different postoperative PFS [0 point, 8.0 months; 1 point, 13.7 months; 2 points, 18.0 months; 3 points, 34.5 months] [P=0.004, oneway ANOVA]. The simple scale we devised comprised of the three pre-operative prognostic factors can significantly distinguish patients with different post-operative survival after initial treatment of astrocytomas with surgery