Prognostic Factors for Survival in Pediatric Diffuse Midline Gliomas: The Importance of T2 FLAIR Missmatch Sign and Nimotuzumab Therapy


VURAL Ö., YAZOL M., TOPUZ TÜRKCAN B., OKUR A., BÖRCEK A. Ö., PINARLI F. G., ...More

GAZI MEDICAL JOURNAL, vol.34, no.4, pp.414-418, 2023 (ESCI) identifier identifier

  • Publication Type: Article / Article
  • Volume: 34 Issue: 4
  • Publication Date: 2023
  • Doi Number: 10.12996/gmj.2023.84
  • Journal Name: GAZI MEDICAL JOURNAL
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus, Academic Search Premier
  • Page Numbers: pp.414-418
  • Gazi University Affiliated: Yes

Abstract

Purpose: The aim of this study is to investigate the clinical and radiological features, especially the importance of the T2-FLAIR mismatch sign and the response to treatment of patients diagnosed with diffuse midline gliomas (DMG) in our center. Methods: Eighteen patients treated with a diagnosis of DMG between January 2008 and January 2021 in Gazi University Medical Faculty, Department of Pediatric Oncology were retrospectively evaluated. The radiologycal evaluation was made as T2-FLAIR mismatch sign positive or negative. After a tumor board review, the diagnosis of DMG was made clinically and radiologically and all patients received local radiotherapy. Nimotuzumab was given as monotherapy or in combination with other medications Results: T2-FLAIR mismatch sign was positive for twelve patients and median OS for patients with T2-FLAIR mismatch positive and negative were 12.5 months and 9.2 months respectively (p=0.77). Median PFS for patients with T2-FLAIR mismatch sign positive and negative were 10.6 months and 4.8 months respectively (p=0.84). After nimotuzumab therapy, there was 4 cases with PR (44.4%), and 1 patient with SD (11.1%). Median OS for patients who were treated with and without nimotuzumab were 16.5 and 6.2 months respectively (p<0.05). Median PFS for patients who were treated with and without nimotuzumab were 13.3 and 3.7 months respectively (p<0.05). Conclusion: In conclusion, DMGs have poor prognosis. In our study patients with T2-FLAIR mismatch sign positive had better prognosis so it can be used as an imaging marker for prognosis. Nimotuzumab therapy may be a promising treatment option for DMG.