Abstract 5259: Clinical feature of end-stage cerebral glioblastomas

Abstract Glioblastoma is the most common and aggressive primary brain tumor, and even with the best treatment, the tumor repeatedly recurs and grows, eventually invading the entire brain. There are few reports on the pathogenesis and pathological search in the terminal stage of glioblastoma. In this study, we report the pathological analysis of glioblastoma cases that we were able to perform from initial treatment to confirmation of death at our hospital. We analyzed 26 glioblastoma cases (including 18 autopsied cases) treated at our hospital from initial treatment to death. The mean age of the 26 patients was 60.7 years, and the mean overall survival was 16.7 months. The duration of clinical symptoms was 36.2 days from coma to death, and 12 days from the appearance of respiratory depression to death. Psychiatric symptoms and central fever were observed in patients with intrathecal dissemination. Steroids and antiepileptic drugs were often continued after completion of active treatment. Patients with intrathecal dissemination progressed rapidly and presented with a variety of symptoms, including psychiatric symptoms, headache, neck pain, and central fever. In addition, there was a case of diffuse infiltration from the brain parenchyma to the periventricular area in a patient treated with bevacizumab, suggesting the possibility of a change in the form of recurrence. In the terminal stage of glioblastoma, hypoxemia due to disturbance of respiratory center progresses from impaired consciousness to death. Convulsive seizures are rare in the dying stage, and continuation of antiepileptic drugs should be considered. Although many patients develop from local recurrence, it was suggested that new treatment may change the mode of recurrence or alter the trait of tumor cells. In recent years, the number of patients receiving home care and end-of-life care has been increasing due to the improvement of medical systems such as home care. Further investigation of the pathophysiology is necessary for better end-of-life care. Citation Format: Norihiko Saito, Nozomi Hirai, Naoki Kushida, Sho Sato, Yu Hiramoto, Satoshi Fujita, Haruo Nakayama, Morito Hayashi, Keisuke Ito, Takatoshi Sakurai, Satoshi Iwabuchi. Clinical feature of end-stage cerebral glioblastomas [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5259.