Pineal Region Glioblastomas: Clinical Characteristics, Treatment, and Survival Outcome

World Neurosurg. 2021 Feb:146:e799-e810. doi: 10.1016/j.wneu.2020.11.016. Epub 2020 Nov 10.

Abstract

Objective: Given the rarity of patients with pineal glioblastoma (GBM), clinical characteristics, treatment, and prognostic factors are not well characterized. This study aimed to investigate these characteristics and identify the prognostic factors of overall survival (OS).

Methods: A retrospective analysis of newly diagnosed patients with pineal GBM, including our 3 cases and an additional 44 cases from published articles, was conducted. Survival analysis was performed by Kaplan-Meier analysis and Cox regression analysis was used to determine the prognostic factors.

Results: A total of 47 patients (28 males and 19 females) were enrolled, with a median age of 46 years (range, 5-74 years). Forty-four patients (90.9%) had preoperative obstructive hydrocephalus. Among 38 patients, 21 (55.3%) had distal leptomeningeal dissemination. Forty-five patients (95.7%) had resection/biopsy, 6 of whom had gross total resection, 22 had subtotal resection, 7 had partial resection, and 10 had biopsy. Adjuvant therapy included radiotherapy in 36 patients and chemotherapy in 27 patients. The median OS was 10.0 months. The 6-month, 1-year, and 2-year survival was 68.0%, 42.6%, and 17.0%, respectively. Cox regression analysis showed that patients receiving biopsy (P = 0.042) or chemotherapy (P = 0.029) had the better OS and these were regarded as independent prognostic factors. Further survival analysis showed that chemoradiotherapy had better survival benefit than other regimens.

Conclusions: In this study, we summarized the characteristics of patients with pineal GBM and showed the correlation between clinical characteristics and prognosis. This study may give readers a deep understanding of these rare GBMs and provide some references for future management.

Keywords: Glioblastoma; H3K27M; Pineal region; Prognostic factors; Survival analysis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brain Neoplasms / therapy*
  • Chemoradiotherapy, Adjuvant*
  • Chemotherapy, Adjuvant*
  • Child
  • Child, Preschool
  • Female
  • Glioblastoma / therapy*
  • Humans
  • Male
  • Middle Aged
  • Neurosurgical Procedures*
  • Pineal Gland*
  • Pinealoma / therapy*
  • Prognosis
  • Proportional Hazards Models
  • Radiotherapy, Adjuvant*
  • Survival Rate
  • Young Adult