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CC BY-NC-ND 4.0 · Asian J Neurosurg 2013; 8(01): 9-14
DOI: 10.4103/1793-5482.110274
ORIGINAL ARTICLE

Protective effect on normal brain tissue during a combinational therapy of 2-deoxy-d-glucose and hypofractionated irradiation in malignant gliomas

Neelam Venkataramanaa
Global Neuro and Spine Institute, BGS Global Hospital, Bangalore
,
P Venkatesh
1   Manipal Institute for Neurological Disorders, Manipal Hospital
,
B Dwarakanath
2   Institute of Nuclear Medicine and Allied Sciences, Delhi
,
S Vani
3   National Institute of Mental Health and Neurosciences, Bangalore
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Purpose: To investigate the effect of 2-deoxy-D-glucose (2-DG), an inhibitor of glucose transport and glycolysis, on glioblastoma and the normal brain tissue during combined treatment with hypofractionated radiotherapy. Materials and Methods: Twenty patients with malignant gliomas (18 Glioblastoma Multiformae, 2 Anasplastic Astrocytoma grade III) following surgery were treated weekly (once) with 2-DG, (250 mg/kg body weight), followed by 5 Gy of radiation to the tumor bed per fraction for 7 weeks. Clinical evaluation, complete hemogram, and random blood sugar levels were carried out in each cycle. Follow-up computed tomography (CT)/magnetic resonance imaging (MRI) was done to evaluate radiation-induced changes. Kernofsky Performance scale (KPS) was recorded preoperatively; postoperatively, and post-therapy till the last follow-up. Results: Twenty patients were recruited for this trail; 19 of them completed the treatment and 1 discontinued. The survival period ranged between 6 and 36 months after the treatment, with a median survival of 14 months. CT and MRI revealed significant tumor necrosis. Histological evidence from the tissue during reexploration confirms the hypothesis of protective effect of 2-DG on normal brain. KPS was above 80% in majority of the patients, 6 months after the surgery. Conclusion: Radiotherapy coupled with 2-DG enhances tumor necrosis selectively and significantly while the normal brain gets relatively protected. This has been reflected in our study both clinically by preservation of quality-of-life and pathologically by retaining the integrity of normal brain architecture.

Key-words:

2-deoxy-D-glucose - malignant gliomas - neural protection - radionecrosis - radiotherapy - quality-of-life


Publication History

Article published online:
27 September 2022

© 2013. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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