Abstract
Gliomas are a family of primary central nervous system tumors of variable malignancy that are derived from supporting glia (astrocytes, oligodendrocytes, ependymal cells) or their progenitors/stem cells. There are two potential strategies to prevention: preventing gliomas from forming and preventing lower-grade gliomas from developing into higher-grade gliomas. Each would lower time-dependent mortality. Each also depends on an understanding of what causes gliomas so that these factors can be modulated. In this presentation, I will discuss primary prevention, chemoprevention, and screening. I will first focus on the known chromosomal, genetic, and protein changes associated with the different histologic varieties of glioma and the environmental, hereditary, and infectious/viral factors that may promote glioma development and malignant progression. I will discuss a number of clinical scenarios that eventuate from the known genetic patterns of these tumors and the changes in genetic patterns that reflect malignant progression. The basic thinking is that if one could prevent specific gene mutations and/or deletions or gains of specific chromosomes that lead to the development of low-grade (WHO 2) gliomas, then theoretically this would reduce the occurrence of high-grade (WHO 3 and 4) gliomas and hence the almost certain death that now is the fate of most patients with these tumors. In the case of de novo WHO 3 and 4 tumors, being able to prevent or counter specific gene mutations and/or the deletion of specific chromosomes would in itself reduce the occurrence of these gliomas and increase survival. Alternatively, a curative treatment for low-grade glioma that prevents these chromosomal/gene changes would prevent some glioblastomas (WHO 4) from forming and would have the same desired effect on survival. Obviously, for the latter to be achieved, we must also be able to diagnose and treat low-grade gliomas earlier.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Anonymous (2005) Central Brain Tumor Registry of United States Special Data Analysis (December 15, 2005)
Austin SG, Schnatter AR (1983) A cohort mortality study of petrochemical workers. J Occup Med 25:304–312
Bauman G, Lote K, Larson D, Stalpers L, Leighton C, Fisher B, Wara W, Macdonald D, Stitt L, Cairncross JG (1999) Pretreatment factors predict overall survival for patients with low-grade glioma: A recursive partitioning analysis. Intl J Radiat Oncol Biol Phy 45:923–929
Beall C, Delzell E, Rodu B, Sathiakumar N, Lees PS, Breysse PN, Myers S (2001) Case-control study of intracranial tumors among employees at a petrochemical research facility. J Occup Environ Med 43:1103–1113
Carozza SE, Wrensch M, Miike R, Newman B, Olshan AF, Savitz DA, Yost M, Lee M (2000) Occupation and adult gliomas. Am J Epidemiol 152:838–846
Carreon T, Butler MA, Ruder AM, Waters MA, Davis-King KE, Calvert GM, Schulte PA, Connally B, Ward EM, Sanderson WT, Heineman EF, Mandel JS, Morton RF, Reding DJ, Rosenman KD, Talaska G, Cancer B (2005) Gliomas and farm pesticide exposure in women: the Upper Midwest Health Study. Environ Health Perspect 113:546–551
Chen P, Aldape K, Wiencke JK, Kelsey KT, Miike R, Davis RL, Liu J, Kesler-Diaz A, Takahashi M, Wrensch M (2001) Ethnicity delineates different genetic pathways in malignant glioma. Cancer Res 61:3949–3954
Davis FG, Preston-Martin S (1999) Epidemiology. Incidence and survival. In: Bigner DD, McLendon RE, Bruner JM (eds) Russell and Rubinstein’s pathology of tumors of the nervous system. Arnold, London, pp 7–11
El-Zein R, Minn Y, Wrensch M, Bondy ML (2002) Epidemiology of brain tumors. In: Levin VA (ed) Cancer in the nervous system. Oxford University Press, Oxford, pp 252–268
Engels EA, Sarkar C, Daniel RW, Gravitt PE, Verma K, Quezado M, Shah KV (2002) Absence of simian virus 40 in human brain tumors from northern India. Int J Cancer 101:348–352
Fisher BJ, Leighton CC, Vujovic O, Macdonald DR, Stitt L (2001) Results of a policy of surveillance alone after surgical management of pediatric low grade gliomas. Int J Radiat Oncol Biol Phys 51:704–710
Floderus B, Persson T, Stenlund C, Wennberg A, Ost A, Knave B (1993) Occupational exposure to electromagnetic fields in relation to leukemia and brain tumors: a case-control study in Sweden. Cancer Causes Control 4:465–476
Grayson JK (1996) Radiation exposure, socioeconomic status, and brain tumor risk in the US Air Force: a nested case-control study. Am J Epidemiol 143:480–486
Gurney JG, Mueller BA, Davis S, Schwartz SM, Stevens RG, Kopecky KJ (1996) Childhood brain tumor occurrence in relation to residential power line configurations, electric heating sources, and electric appliance use. Am J Epidemiol 143:120–128
Inskip PD, Tarone RE, Hatch EE, Wilcosky TC, Shapiro WR, Selker RG, Fine HA, Black PM, Loeffler JS, Linet MS (2001) Cellular-telephone use and brain tumors. N Engl J Med 344:79–86
Keles GE, Lamborn KR, Berger MS (2001) Low-grade hemispheric gliomas in adults: a critical review of extent of resection as a factor influencing outcome. J Neurosurg 95:735–745
Kheifets LI, Sussman SS, Preston-Martin S (1999) Childhood brain tumors and residential electromagnetic fields (EMF). Rev Environ Contam Toxicol 159:111–129
Kleihues P, Ohgaki H (1999) Primary and secondary glioblastomas: from concept to clinical diagnosis. Neuro-oncol 1:44–51
Kleihues P, Ohgaki H (2000) Phenotype vs genotype in the evolution of astrocytic brain tumors. Toxicol Pathol 28:164–170
Kleihues P, Louis DN, Scheithauer BW, Rorke LB, Reifenberger G, Burger PC, Cavenee WK (2002) The WHO classification of tumors of the nervous system. J Neuropathol Exp Neurol 61:215–225; discussion 226–219
Kyritsis AP, Bondy ML, Xiao M, Berman EL, Cunningham JE, Lee PS, Levin VA, Saya H (1994) Germline p53 gene mutations in subsets of glioma patients. J Natl Cancer Inst 86:344–349
Kyritsis AP, Bondy ML, Hess KR, Cunningham JE, Zhu D, Amos CJ, Yung WK, Levin VA, Bruner JM (1995) Prognostic significance of p53 immunore-activity in patients with glioma. Clin Cancer Res 1:1617–1622
Kyritsis AP, Xu R, Bondy ML, Levin VA, Bruner JM (1996) Correlation of p53 immunoreactivity and sequencing in patients with glioma. Mol Carcinog 15:1–4
Lee WJ, Colt JS, Heineman EF, McComb R, Weisenburger DD, Lijinsky W, Ward MH (2005) Agricultural pesticide use and risk of glioma in Nebraska, United States. Occup Environ Med 62:786–792
Levin VA (1996) Controversies in the treatment of low-grade astrocytomas and oligodendrogliomas. Curr Opin Oncol 8:175–177
Levin VA, Prados MD, Yung WK, Gleason MJ, Ictech S, Malec M (1992) Treatment of recurrent gliomas with eflornithine. J Natl Cancer Inst 84:1432–1437
Levin VA, Uhm JH, Jaeckle KA, Choucair A, Flynn PJ, Yung WKA, Prados MD, Bruner JM, Chang SM, Kyritsis AP, Gleason MJ, Hess KR (2000) Phase III randomized study of postradiotherapy chemotherapy with alpha-difluoromethylornithine-procarbazine, N-(2-chloroethyl)-N’-cyclohexyl-Nnitrosurea, vincristine (DFMO-PCV) versus PCV for glioblastoma multiforme. Clin Cancer Res 6:3878–3884
Levin VA, Leibel SA, Gutin PH (2001) Neoplasms of the central nervous system. In: DeVita VTJ, Hellman S, Rosenberg SA (eds) Cancer: principles and practice of oncology. Lippincott-Raven, Philadelphia, pp 2100–2160
Levin VA, Hess KR, Choucair A, Flynn PJ, Jaeckle KA, Kyritsis AP, Yung WK, Prados MD, Bruner JM, Ictech S, Gleason MJ, Kim HW (2003) Phase III randomized study of postradiotherapy chemotherapy with combination alpha-difluoromethyl-ornithine-PCV versus PCV for anaplastic gliomas. Clin Cancer Res 9:981–990
Littman AJ, Thornquist MD, White E, Jackson LA, Goodman GE, Vaughan TL (2004) Prior lung disease and risk of lung cancer in a large prospective study. Cancer Causes Control 15:819–827
Louis DM, Cavenee WK (2001) Molecular biology of central nervous system neoplasms. In: DeVita VTJ, Hellman S, Rosenberg SA (eds) Cancer: principles and practice of oncology. Lipincott-Raven, Philadelphia, pp 2091–2099
Loyant V, Jaffre A, Breton J, Baldi I, Vital A, Chapon F, Dutoit S, Lecluse Y, Loiseau H, Lebailly P, Gauduchon P (2005) Screening of TP53 mutations by DHPLC and sequencing in brain tumours from patients with an occupational exposure to pesticides or organic solvents. Mutagenesis 20:365–373
Martin JD, King DM, Slauch JM, Frisque RJ (1985) Differences in regulatory sequences of naturally occurring JC virus variants. J Virol 53:306–311
Moss AR (1985) Occupational exposure and brain tumors. J Toxicol Environ Health 16:703–711
Muller W, Afra D, Schroder R (1977a) Supratentorial recurrences of gliomas. Morphological studies in relation to time intervals with astrocytomas. Acta Neurochir 37:75–91
Muller W, Afra D, Schroder R (1977b) Supratentorial recurrences of gliomas. Morphological studies in relation to time intervals with oligodendrogliomas. Acta Neurochir 39:15–25
Musicco M, Filippini G, Bordo BM, Melotto A, Morello G, Berrino F (1982) Gliomas and occupational exposure to carcinogens: case-control study. Am J Epidemiol 116:782–790
Musicco M, Sant M, Molinari S, Filippini G, Gatta G, Berrino F (1988) A case-control study of brain gliomas and occupational exposure to chemical carcinogens: the risk to farmers. Am J Epidemiol 128:778–785
Neuberger JS, Ward-Smith P, Morantz RA, Tian C, Schmelzle KH, Mayo MS, Chin TD (2003) Brain cancer in a residential area bordering on an oil refinery. Neuroepidemiology 22:46–56
Nomura K, Committee of Brain Tumor Registry of Japan (2003) Report of Brain Tumor Registry of Japan. Neurologia Med Chir 43:1–111
Ohgaki H, Kleihues P (2005) Population-based studies on incidence, survival rates, and genetic alterations in astrocytic and oligodendroglial gliomas. J Neuropathol Exp Neurol 64:479–489
Olin RG, Ahlbom A, Lindberg-Navier I, Norell SE, Spannare B (1987) Occupational factors associated with astrocytomas: a case-control study. Am J Ind Med 11:615–625
Prados MD, Edwards MS, Rabbitt J, Lamborn K, Davis RL, Levin VA (1997) Treatment of pediatric low-grade gliomas with a nitrosourea-based multiagent chemotherapy regimen. J Neuro-oncol 32:235–241
Preston-Martin S (1996) Epidemiology of primary CNS neoplasms. Neurol Clin 14:273–290
Rencic A, Gordon J, Otte J, Curtis M, Kovatich A, Zoltick P, Khalili K, Andrews D (1996) Detection of JC virus DNA sequence and expression of the viral oncoprotein, tumor antigen, in brain of immunocom-petent patient with oligoastrocytoma. Proc Natl Acad Sci U S A 93:7352–7357
Rollison DE, Utaipat U, Ryschkewitsch C, Hou J, Goldthwaite P, Daniel R, Helzlsouer KJ, Burger PC, Shah KV, Major EO (2005) Investigation of human brain tumors for the presence of polyomavirus genome sequences by two independent laboratories. Int J Cancer 113:769–774
Saha S, Hoerger TJ, Pignone MP, Teutsch SM, Helfand M, Mandelblatt JS (2001) The art and science of incorporating cost effectiveness into evidence-based recommendations for clinical preventive services. Am J Prev Med 20:36–43
Sakata K, Hareyama M, Komae T, Shirato H, Watanabe O, Watarai J, Takai K, Yamada S, Tsuchida E, Sakai K (2001a) Supratentorial astrocytomas and oligodendrogliomas treated in the MRI era. Jpn J Clin Oncol 31:240–245
Schiffer D, Dutto A, Cavalla P, Bosone I, Chio A, Villani R, Bellotti (1997) Prognostic factors in oligodendroglioma Canadian Journal of Neurological Sciences 24:313–319
Schlehofer B, Blettner M, Preston-Martin S, Niehoff D, Wahrendorf J, Arslan A, Ahlbom A, Choi WN, Giles GG, Howe GR, Little J, Menegoz F, Ryan P (1999) Role of medical history in brain tumour development. Results from the international adult brain tumour study. Int J Cancer 82:155–160
Shaw EG, Scheithauer BW, O’Fallon JR (1993) Management of supratentorial low-grade gliomas. Oncology (Huntingt) 7:97–104
Shaw E, Arusell R, Scheithauer B, O’Fallon J, O’Neill B, Dinapoli R, Nelson D, Earle J, Jones C, Cascino T, Nichols D, Ivnik R, Hellman R, Curran W, Abrams R (2002) Prospective randomized trial of low-versus high-dose radiation therapy in adults with supratentorial low-grade glioma: initial report of a North Central Cancer Treatment Group/Radiation Therapy Oncology Group/Eastern Cooperative Oncology Group study. J Clin Oncol 20:2267–2276
Simpson JR, Horton J, Scott C, Curran WJ, Rubin P, Fischbach J, Isaacson S, Rotman M, Asbell SO, Nelson JS et al (1993) Influence of location and extent of surgical resection on survival of patients with glioblastoma multiforme: results of three consecutive Radiation Therapy Oncology Group (RTOG) clinical trials. Int J Radiat Oncol Biol Phys 26:239–244
Teta MJ, Ott MG, Schnatter AR (1991) An update of mortality due to brain neoplasms and other causes among employees of a petrochemical facility. J Occup Med 33:45–51
Tynes T, Haldorsen T (1997) Electromagnetic fields and cancer in children residing near Norwegian high-voltage power lines. Am J Epidemiol 145:219–226
Winger MJ, Macdonald DR, Cairncross JG (1989) Supratentorial anaplastic gliomas in adults: The prognostic importance of extent of resection and prior low-grade glioma. J Neurosurg 71:487–493
Wrensch M, Lee M, Miike R, Newman B, Barger G, Davis R, Wiencke J, Neuhaus J (1997) Familial and personal medical history of cancer and nervous system conditions among adults with glioma and controls. Am J Epidemiol 145:581–593
Zahm SH, Devesa SS (1995) Childhood cancer: overview of incidence trends and environmental carcinogens. Environ Health Perspect 103[Suppl 6]:177–184
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2007 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Levin, V.A. (2007). Are Gliomas Preventable?. In: Senn, HJ., Kapp, U. (eds) Cancer Prevention. Recent Results in Cancer Research, vol 174. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-37696-5_18
Download citation
DOI: https://doi.org/10.1007/978-3-540-37696-5_18
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-37695-8
Online ISBN: 978-3-540-37696-5
eBook Packages: MedicineMedicine (R0)