Abstract | BACKGROUND: METHODS: RESULTS: Thirty-two of 50 (64%) patients were positive for anti-CMV IgG before radio(chemo) therapy. Fifteen of those 32 (48%) developed viremia during or up to 28 days after treatment. Thirteen of those 15 (87%) required treatment for CMV-associated encephalopathy. MRIs were negative for disease progression, edema, or bleeding. None of the patients negative for anti-CMV IgG developed viremia, suggesting a reactivation rather than a primary infection.In the group at risk consisting of anti-CMV IgG+ patients, age >65 (P = .004) and the amount of dexamethasone taken during radio(chemo) therapy (P = .004) were associated with an increased risk for CMV-associated encephalopathy. One hundred and fifty days after the start of radio(chemo) therapy, survival was 74% (14/19) (no encephalopathy) versus 54% (7/13) ( encephalopathy) (odds ratio, 0.42; 95% CI, 0.03-1.86; P = .25). CONCLUSION: CMV reactivation frequently causes encephalopathy during radio(chemo) therapy of the brain. The unexpected high incidence of this infection makes it highly clinically relevant for every treating physician.
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Authors | Nicole L Goerig, Benjamin Frey, Klaus Korn, Bernhard Fleckenstein, Klaus Überla, Manuel A Schmidt, Arnd Dörfler, Tobias Engelhorn, Ilker Eyüpoglu, Paul F Rühle, Florian Putz, Sabine Semrau, Udo S Gaipl, Rainer Fietkau |
Journal | Neuro-oncology
(Neuro Oncol)
Vol. 18
Issue 12
Pg. 1664-1672
(12 2016)
ISSN: 1523-5866 [Electronic] England |
PMID | 27286796
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © The Author(s) 2016. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: [email protected]. |
Topics |
- Aged
- Brain
(virology)
- Brain Diseases
(epidemiology, etiology)
- Brain Neoplasms
(drug therapy, epidemiology, radiotherapy, secondary)
- Chemoradiotherapy
(adverse effects)
- Cytomegalovirus Infections
(complications, epidemiology)
- Female
- Humans
- Male
- Middle Aged
- Opportunistic Infections
(complications, epidemiology)
- Prospective Studies
- Survival Analysis
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