Malignant transformation of low-grade gliomas in patients undergoing adjuvant therapy.

Abstract

Low-grade gliomas (LGG) comprise nearly 15-20% of all central nervous system glial tumors. Several factors have been recognized as playing role in LGG malignant transformation (MT). A breakthrough analysis of a multidisciplinary group pointed that temozolomide may play a role in MT of LGGs. We analyzed the prevalence of MT in LGG patients submitted to adjuvant therapy (AT). We analyzed the medical charts of 43 patients with LGG submitted to surgery or biopsy and attending at Hospital do Servidor Público Estadual de São Paulo (São Paulo, Brazil), consecutively diagnosed from 1995 to 2013. 43 patients (24 women and 19 men) were evaluated, with mean age of 45.3years. According to histology, 30 were astrocytomas (70%), 12 (27%) were oligodendrogliomas, and 1 (3%) were mixed glioma. Mean follow-up time was 4.2years with the standard deviation of 2.1. Twenty-eight patients did not receive adjuvant therapy and 15 received adjuvant therapy. From 43 patients with complete follow-up, 21 (48%) experienced malignant transformation. Among such patients, nine were users of AT. Forty-eight percent of patients presented MT, being 60% in the AT group and 42.8% without AT. Our analysis revealed a high prevalence of MT in patients undergoing AT, higher than in patients without AT.