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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

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Signifcance of COX-2, VEGF expression and microvessel density for antiangiogenic treatment of glioblastoma multiforme

Bedeutung der COX-II und VEGF-Expression sowie der Mikrogefäßdichte für einen antiangiogenen Therapieansatz bei Patienten mit Glioblastoma multiforme

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  • corresponding author Jochen Tüttenberg - Neurochirurgische Klinik, Universitätsklinikum Mannheim, Mannheim
  • R. Grobholz - Pathologisches Institut, Universitätsklinikum Mannheim, Mannheim
  • T. Korn - Neurochirurgische Klinik, Universitätsklinikum Mannheim, Mannheim
  • F. Wenz - Radioonkologische Klinik, Universitätsklinikum Mannheim, Mannheim
  • R. Erber - Neurochirurgische Klinik, Universitätsklinikum Mannheim, Mannheim
  • P. Vajkoczy - Neurochirurgische Klinik, Universitätsklinikum Mannheim, Mannheim

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.04.04

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0047.shtml

Published: April 23, 2004

© 2004 Tüttenberg et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

Glioblastoma multiforme (GBM) is the prototype of an angio-genic tumour. To evaluate the effects of an antiangiogenic treatment by a metronomic scheduling of Temozolomide (TMZ) and the COX-2 inhibitor Rofecoxib, expression of COX-2, VEGF and micro-vessel densitiy was evaluated and correlated with the therapeutic outcome.

Methods

Patients with GBM (n=13) were operated followed by radiotherapy and a continuous low dose therapy of 10 mg/m2 TMZ and 25 mg Rofecoxib/day. Tumour tissue was examined immunohistochemically for COX-2, VEGF and CD34 by monoclonal antibodies. Microvessel densitiy (MVD) was determined by morphometry. Mean follow-up was 14.4 ± 5.8 months. Therapy response was monitored by MR imaging and neurological examination.

Results

The mean time to progression of 10.6 ± 4.3 months in the response group was significantly higher compared to 3.8 ± 1.3 months in the non-responder group. The mean MVD was significantly higher in the responder group than in the non-responder group (5.43 ± 2.2% vs. 3.0 ± 1.5%). Tumours with a MVD <3.5% showed an earlier progress than tumours with a MVD >3.5%. Expression of COX-2 was higher in tumours with a high MVD than in tumours with a low MVD. Also, COX-2 showed a significantly stronger expression in responders than in non-responders. VEGF also exhibited a stronger expression in tumours with a high MVD.

Conclusions

Adjuvant metronomic chemotherapy with TMZ and Rofecoxib shows a promising effect in highly vascularized glioblastomas. Expression of COX-2, VEGF and MVD seem to be important factors in predicting a successful antiangiogenic adjuvant treatment.