Generic placeholder image

Current Cancer Therapy Reviews

Editor-in-Chief

ISSN (Print): 1573-3947
ISSN (Online): 1875-6301

Review Article

Central Nervous System Neoplasms in Hong Kong: An Inscription of Local Studies

Author(s): Jenny K.S. Pu and Dora L.W. Kwong*

Volume 16, Issue 3, 2020

Page: [196 - 206] Pages: 11

DOI: 10.2174/1573394715666190126153006

Price: $65

Abstract

A registry of brain and central nervous system (CNS) tumor patients in Hong Kong comprising of data from both public and private neurosurgical practices (with approximately 98% patients of Chinese origin), suggested geographical or racial variations in disease incidence. The data confers the finding of a comparatively lower incidence rate of meningioma and malignant gliomas as in other parts of Southeast Asia.

With data suggesting epidemiological difference, the treatment response, particularly in highgrade glioma, was studied. Patients suffering from glioblastoma (GBM) in Hong Kong received the standard of care, which involves safe, maximal resection followed by the Stupp regime. 5-aminolevulinic acid (5-ALA)-based fluorescence-guided surgery was found to be feasible and safe to adopt in the treatment of local WHO Grade III & IV gliomas patients. Survival benefit was seen in a group of patients using extended adjuvant temozolomide (TMZ) treatment for newly diagnosed GBM as compared to those treated with the standard 6 cycles. Salvage therapies with either single agent bevacizumab or bevacizumab plus irinotecan appeared to be effective treatment options in Hong Kong patients with recurrent malignant glioma, with a good associated 6- month progression-free survival (PFS) rate which was comparable to previously published overseas data in this disease type in the same overall population.

Keywords: Epidemiology, central nervous system, Hong Kong, neurosurgery, extended adjuvant chemotherapy, targeted therapy.

Graphical Abstract
[1]
Ferlay JS, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Cancer Incidence and Mortality Worldwide: IARC Cancer Base No 10. International Agency for Research on Cancer Lyon, France 2008.
[2]
Darefsky AS, Dubrow R. International variation in the incidence of adult primary malignant neoplasms of the brain and central nervous system. Cancer Causes Control 2009; 20(9): 1593-604.
[3]
SEER. Brain and other Nervous System in the United States, 2006-2010. SEER Cancer Statistic Review 2010.
[4]
McCarthy BJ, Schellinger KA, Propp JM, Kruchko C, Malmer B. A case for the worldwide collection of primary benign brain tumors. Neuroepidemiology 2009; 33(3): 268-75.
[5]
Registry HKC. Brain and Nervous System Tumours in Hong Kong 2013.
[6]
Ho-cheong H. Intracranial tumours among Chinese in Hong Kong. Surg Neurol 1979; 12(4): 317-8.
[7]
Ng HK, Poon WS, South JR, Lee JC. Tumours of the central nervous system in Chinese in Hong Kong: A histological review. Aust N Z J Surg 1988; 58(7): 573-8.
[8]
Chan G. Recent advances in childhood brain tumours. HK J Paediatr 2006; 11: 3-12.
[9]
Registry HKC. Brain and Nervous System Tumours in Hong Kong 2006.
[10]
Thomas DGT, Graham DI. The clinical study of gliomas. In: Brain Tumors: Scientific Basis, Clinical Investigation and Current Therapy. Johns Hopkins University Press USA 1980.
[11]
van Breemen MS, Wilms EB, Vecht CJ. Epilepsy in patients with brain tumours: Epidemiology, mechanisms, and management. Lancet Neurol 2007; 6(5): 421-30.
[12]
Kerkhof M, Dielemans JCM, van Breemen MS, Zwinkels H. Effect of valproic acid on seizure control and on survival in patients with glioblastoma multiforme. Neuro-oncol 2013; 15(7): 961-7.
[13]
Laterra JBH. Diseases of the Nervous System: Clinical Neuroscience and Therapeutic Principles. 3rd ed. Primary brain tumours in adults. A.M. Asbury, I.; McKhann, G.; Goadsby, P.; McArthur, J. ed.; Cambridge University Press: UK,. 2002.
[14]
Stupp R, Mason WP, van den Bent M. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 2005; 352(10): 987-96.
[15]
Chan DT, Poon WS, Chan YL, Ng HK. Temozolomide in the treatment of recurrent malignant glioma in Chinese patients. Hong Kong Med J 2005; 11(6): 452-6.
[16]
Vredenburgh JJ, Desjardins A, Herndon 2nd JE. Bevacizumab plus irinotecan in recurrent glioblastoma multiforme. J Clin Oncol 2007; 25(30): 4722-9.
[17]
Friedman HS, Prados MD, Wen PY. Bevacizumab alone and in combination with irinotecan in recurrent glioblastoma. J Clin Oncol 2009; 27(28): 4733-40.
[18]
Lacroix M, Abi-Said D, Fourney DR. A multivariate analysis of 416 patients with glioblastoma multiforme: Prognosis, extent of resection, and survival. J Neurosurg 2001; 95(2): 190-8.
[19]
Stummer W, Reulen HJ, Novotny A, Stepp H, Tonn JC. Fluorescence-guided resections of malignant gliomas--an overview. Acta Neurochir Suppl 2003; 88: 9-12.
[20]
Stummer W, Stepp H, Möller G, Ehrhardt A, Leonhard M, Reulen HJ. Technical principles for protoporphyrin-IX-fluorescence guided microsurgical resection of malignant glioma tissue. Acta Neurochir (Wien) 1998; 140(10): 995-1000.
[21]
Stummer W, Novotny A, Stepp H, Goetz C, Bise K, Reulen HJ. Fluorescence-guided resection of glioblastoma multiforme by using 5-aminolevulinic acid-induced porphyrins: A prospective study in 52 consecutive patients. J Neurosurg 2000; 93(6): 1003-13.
[22]
Nabavi A, Thurm H, Zountsas B. Five-aminolevulinic acid for fluorescence-guided resection of recurrent malignant gliomas: A phase ii study. Neurosurgery 2009; 65(6): 1070-6. discussion 1076-7..
[23]
Widhalm G, Wolfsberger S, Minchev M. 5-Aminolevulinic acid is a promising marker for detection of anaplastic foci in diffusely infiltrating gliomas with nonsignificant contrast enhancement. Cancer 2010; 116(6): 1545-52.
[24]
Roberts DW, Valdés PA, Paulsen KD. Adjuncts for maximizing resection: 5-aminolevuinic acid. Clin Neurosurg 2012; 59: 75-8.
[25]
Barbagallo GM, Paratore S, Caltabiano R. Long-term therapy with temozolomide is a feasible option for newly diagnosed glioblastoma: A single-institution experience with as many as 101 temozolomide cycles. Neurosurg Focus 2014; 37(6) E4
[26]
Seiz M, Krafft U, Freyschlag CF. Long-term adjuvant administration of temozolomide in patients with glioblastoma multiforme: Experience of a single institution. J Cancer Res Clin Oncol 2010; 136(11): 1691-5.
[27]
Mannas JP, Lightner DD, Defrates SR, Pittman T, Villano JL. Long-term treatment with temozolomide in malignant glioma. J Clin Neurosci 2014; 21(1): 121-3.
[28]
Roldan Urgoiti GB, Singh AD, Easaw JC. Extended adjuvant temozolomide for treatment of newly diagnosed glioblastoma multiforme. J Neurooncol 2012; 108(1): 173-7.
[29]
Hsieh SY, Chan DT, Kam MK. Feasibility and safety of extended adjuvant temozolomide beyond six cycles for patients with glioblastoma. Hong Kong Med J 2017; 23(6): 594-8.
[30]
Blumenthal DT, Gorila T, Gilbert MK. Is more better? The impact of extended adjuvant temozolomide in newly diagnosed glioblastoma: a secondary analysis of EORTC and NRG Oncology/RTOG. Neuro-oncol 2017; 19(8): 1119-26.
[31]
Perry JR, Bélanger K, Mason WP. Phase II trial of continuous dose-intense temozolomide in recurrent malignant glioma: RESCUE study. J Clin Oncol 2010; 28(12): 2051-7.
[32]
Tsai CM, Au JS, Chang GC, Cheng AC, Zhou C, Wu YL. Safety and efficacy of first-line bevacizumab-based therapy in advanced non small cell lung cancer (NSCLC): results of the SAiL study (MO19390). J Thorac Oncol 2011; 6(6): 1092-7.
[33]
Reck M, von Pawel J, Zatloukal P. Phase III trial of cisplatin plus gemcitabine with either placebo or bevacizumab as first-line therapy for nonsquamous non-small-cell lung cancer: AVAil. J Clin Oncol 2009; 27(8): 1227-34.
[34]
Wu JY, Wu XN, Ding L, et al. Phase I safety and pharmacokinetic study of bevacizumab in Chinese patients with advanced cancer. Chin Med J (Engl) 2010; 123(7): 901-6.
[35]
Pu JK, Chan RTT, Ng GKB, Leung GKK, Hung KN, Fung CF. Using bevacizumab in the fight against malignant glioma: First results in Asian patients. Hong Kong Med J 2011; 17(4): 274-9.
[36]
Wong ET, Hess KR, Gleason MJ. Outcomes and prognostic factors in recurrent glioma patients enrolled onto phase II clinical trials. J Clin Oncol 1999; 17(8): 2572-8.
[37]
Patel M, Siddiqui F, Jin JY, et al. Salvage reirradiation for recurrent glioblastoma with radiosurgery: Radiographic response and improved survival. J Neurooncol 2009; 92(2): 185-91.
[38]
Hashmi A, Guckenberger M, Kersh R, et al. Re-irradiation stereotactic body radiotherapy for spinal metastases: A multi-institutional outcome analysis. J Neurosurg Spine 2016; 25(5): 646-53.
[39]
Jawad MS, Fahim DK, Gerszten PC, et al. on behalf of the Elekta Spine Radiosurgery Research Consortium. Vertebral compression fractures after stereotactic body radiation therapy: A large, multi-institutional, multinational evaluation. J Neurosurg Spine 2016; 24(6): 928-36.
[40]
Thibault I, Campbell M, Tseng CL, et al. Salvage Stereotactic Body Radiotherapy (SBRT) Following In-Field Failure of Initial SBRT for Spinal Metastases. Int J Radiat Oncol Biol Phys 2015; 93(2): 353-60.
[41]
Dahele M, Fehlings MG, Sahgal A. Stereotactic radiotherapy: an emerging treatment for spinal metastases. Can J Neurol Sci 2011; 38(2): 247-50.

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy