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Review
. 2022 Oct;127(10):1134-1141.
doi: 10.1007/s11547-022-01531-3. Epub 2022 Aug 11.

Pleomorphic Xanthoastrocytoma: a single institution retrospective analysis and a review of the literature

Beatrice Detti  1 , Silvia Scoccianti  2 , Virginia Maragna  2 , Sara Lucidi  2 , Michele Ganovelli  2 , Maria Ausilia Teriaca  2 , Saverio Caini  3 , Isacco Desideri  2 , Benedetta Agresti  2 , Daniela Greto  2 , Anna Maria Buccoliero  4 , Alessandro Della Puppa  5   6 , Iacopo Sardi  5   6 , Lorenzo Livi  2
Affiliations
Review

Pleomorphic Xanthoastrocytoma: a single institution retrospective analysis and a review of the literature

Beatrice Detti et al. Radiol Med. 2022 Oct.

Abstract

Background: Pleomorphic xanthoastrocytoma (PXA) is a rare low-grade brain tumor. To date, limited studies have analyzed factors affecting survival outcomes and defined the therapeutic strategy. The aim of this retrospective analysis was to investigate the clinicopathologic characteristics of PXA and identify factors associated with outcomes.

Methods: We retrospectively analyzed a cohort of 16 adult and children patients with PXA who underwent primary resection from 1997 to 2019, referred to our Radiation Oncology Unit and to Meyer's Paediatric Hospital. We also reviewed the relevant literature.

Results: All patients underwent primary surgical resection; 10 patients received adjuvant radiation treatment course, ranging from DTF 54 to 64 Gy; 8 of them received, in addition, concurrent adjuvant chemotherapy; 6 patients underwent only radiological follow-up. After a median follow up was 60 months: median OS was 34.9 months (95% CI 30-218), 1-year OS 87%, 5-years OS 50%, 10-years OS 50%; median PFS 24.4 months (95% CI 13-156), 1-year PFS 80%, 5-years PFS 33%, 10-years PFS 33%. A chi-square test showed a significant association between OS and recurrent disease (p = 0.002) and with chemotherapy adjuvant treatment (p = 0.049). A borderline statistical significant association was instead recognized with BRAF mutation (p = 0.058).

Conclusions: Despite our analysis did not reveal a strong prognostic or predictive factor able to address pleomorphic xanthoastrocytoma management; however, in selected patients could be considered the addition of adjuvant radiation chemotherapy treatment after adequate neurosurgical primary resection. Furthermore, recurrent disease evidenced a detrimental impact on survival.

Keywords: Brain tumor; Pleomorphic Xanthoastrocytoma; Radiotherapy.

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Conflict of interest statement

No conflict of interest to declare.

Figures

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Overall survival analysis
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Progression free survival analysis
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OS by adjuvant RT yes vs. no
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Fig. 4
PFS by adjuvant RT yes vs. no
See this image and copyright information in PMC

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