Abstract | PURPOSE: If routine diagnostics are inconclusive, neurologic deterioration and death of patients with brain cancer are attributed to tumor or therapy. Therefore, diagnosing symptoms of encephalopathy caused by human cytomegalovirus (HCMV) reactivation remains uncommon. We investigated the role of HCMV reactivation in neurologic decline and clinical outcome after the start of radiochemotherapy. EXPERIMENTAL DESIGN: HCMV analyses and extended MRI studies including additional independent retrospective neuroradiologic evaluation were performed at predetermined intervals and in case of sudden neurologic decline for 118 adult patients: 63 histologically proven high-grade gliomas, 55 with brain metastases. Immunophenotyping from simultaneously taken whole-blood samples was carried out to detect immune cells serving as prognostic marker for HCMV-associated complications. Symptomatic viremia and overall survival (OS) were the endpoints. RESULTS: CONCLUSIONS: For patients with brain cancer, HCMV reactivation after the start of radiochemotherapy is a frequent risk for cognitively detrimental but treatable encephalopathy and premature death. Routinely performed HCMV diagnostics, assessing basophil counts and study-based anti-viral regimens, are necessary to combat this hidden threat.See related commentary by Lawler et al., p. 3077.
|
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 | Clinical cancer research : an official journal of the American Association for Cancer Research
(Clin Cancer Res)
Vol. 26
Issue 13
Pg. 3259-3270
(07 01 2020)
ISSN: 1557-3265 [Electronic] United States |
PMID | 32060103
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Comment)
|
Copyright | ©2020 American Association for Cancer Research. |
Topics |
- Adult
- Brain Neoplasms
- Carcinoma, Non-Small-Cell Lung
(therapy)
- Chemoradiotherapy
(adverse effects)
- Cytomegalovirus
- Humans
- Lung Neoplasms
- Retrospective Studies
|