Mrvoljak Midhad, Mishra Shubhendu, Chen Liam, Neil Elizabeth, Ehler Eric, Terezakis Stephanie, Sloan Lindsey
College of Osteopathic Medicine, Des Moines University, Des Moines, IA, United States.
Department of Radiation Oncology, University of Minnesota Medical School, Minneapolis, MN, United States.
Front Oncol. 2025 Feb 4;15:1501466. doi: 10.3389/fonc.2025.1501466. eCollection 2025.
Glioblastoma (GB) is a primary brain tumor that is lethal and challenging to treat. The 3-year overall survival (OS) of patients with this diagnosis has stayed the same since 2005. The patient is a 75-year-old woman who presented with progressive aphasia and was diagnosed with GB (WHO grade 4, IDH1/IDH2 wild type, ATRX intact, p53 and PTEN mutant, BRAF non-mutated, O-methylguanine-DNA methyltransferase promoter methylated) and who underwent surgical resection, hypofractionated radiotherapy (HFRT) using intensity-modulated radiotherapy (IMRT) (4,005 cGy in 15 fractions) alone, and adjuvant temozolomide (TMZ). She was progression-free for approximately 20 months. Although planned, concurrent TMZ was not used during the complete first course of HFRT due to the patient's performance status. After recurrence, another HFRT (35 Gy in 10 fractions) was employed. She was progression-free on imaging for 8 months until a recent follow-up scan showed potential progression radiation-related change. At the time of this case report, her care is still ongoing. This represents a rare case of a long-term survivor of GB who has received two courses of HFRT, a treatment option that is usually used in those with predicted shorter survival times.
胶质母细胞瘤（GB）是一种原发性脑肿瘤，具有致命性且治疗具有挑战性。自2005年以来，患有这种诊断的患者的3年总生存率（OS）一直保持不变。该患者是一名75岁女性，表现为进行性失语，被诊断为GB（世界卫生组织4级，异柠檬酸脱氢酶1/异柠檬酸脱氢酶2野生型，α地中海贫血/智力低下综合征X连锁基因完整，p53和磷酸酶及张力蛋白同源物突变，BRAF未突变，O-甲基鸟嘌呤-DNA甲基转移酶启动子甲基化），并接受了手术切除、单独使用调强放疗（IMRT）的大分割放疗（HFRT）（15次分割，4005 cGy）以及辅助替莫唑胺（TMZ）治疗。她无进展生存了大约20个月。尽管有计划，但由于患者的身体状况，在HFRT的整个第一个疗程中未使用同步TMZ。复发后，采用了另一次HFRT（10次分割，35 Gy）。她在影像学上无进展生存了8个月，直到最近的一次随访扫描显示可能有进展——与放疗相关的变化。在撰写本病例报告时，她的治疗仍在进行中。这是GB长期存活者的罕见病例，该患者接受了两个疗程的HFRT，这是一种通常用于预计生存期较短患者的治疗选择。
