Hout-06. Pattern of Low Field Intensity Recurrence in High-grade Gliomas Following Tumor Treatment Field Therapy
Year: 2018
Type: conference-abstract
Abstract: Glioblastoma (GBM) is an aggressive neoplasm that continues to show recurrence despite recent advances in therapy. Tumor Treating Fields (TTFields) is a non-invasive, regional antimitotic treatment modality, delivering low-intensity (1–3 V/cm), intermediate-frequency (100–300 kHz), alternating electric fields to tumors via transducer arrays placed on the scalp of GBM patients. TTFields disrupts cell division processes in cancer cells. However, some mechanisms of escape have been described, in particular, out-of-field tumor recurrence. The brainstem dose not receive high intensity electric field stimulation during TTFields therapy, and represents one possible region of tumor recurrence following treatment. Six cases were identified via retrospective chart review from multiple providers that have experience with prescribing and planning treatment with TTFields. Clinical and radiographic reviews were performed after de-identification of patient records. Cases were compared according to demographics, tumor location and region of recurrence. The median patient age at diagnosis was 62 years (Range: 10–69) with 3/6 patients being male and 3/6 patients being female. Tumors were initially located in the frontal (3/6), parietal (2/6), and temporal lobes (1/6). Three patients received TTFields therapy at initial diagnosis in combination with surgery and chemoradiation, while the remaining patients received TTFields therapy at initial recurrence in conjunction with bevacizumab. Following TTFields treatment, tumors recurred predominantly in the pons (1/6), left cerebellar peduncles (3/6), and right cerebellar peduncles (2/6). The average time to brainstem recurrence following TTFields therapy was 152 days (Range: 49–228). Treatment options for patients with GBM are limited, however TTFields has been shown to improve overall survival when combined with temozolomide. TTFields can only be delivered in therapeutic intensities to the supratentorial brain. Brainstem recurrence may occur as field intensity in the brainstem is sub-therapeutic. Further investigation is warranted to determine optimal treatment for brainstem recurrences for patients receiving TTFields therapy.
Source: Neuro-Oncology
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2899708495