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Page 4 of 8 Bellu et al. J Cancer Metastasis Treat 2021;7:29 https://dx.doi.org/10.20517/2394-4722.2021.89

Table 1. Patient, tumor, and treatment characteristics
N (%)
Patients 33
Sex
Male 22 (67)
Female 11 (33)
ECOG PS
0-1 21 (64)
≥ 2 12 (36)
Biopsy
Yes 22 (67)
No 11 (33)
Histology
Astrocytoma 16 (73)
Oligodendroglioma 6 (27)
MGMT status
Methylated 8/14 (57)
Unmethylated 6/14 (43)
IDH status
Mutated 10/16 (63)
Wild-type 6/16 (37)
Type of treatment
RT + TMZ 9 (27)
TMZ alone 22 (67)
RT alone 2 (6)
Radiological response
CR 1 (3)
PR 9 (27)
SD 15 (45)
PD 8 (25)
Second-line treatment 13 (59)
RT + TMZ 1 (5)
CT alone 10 (45)
RT alone 2 (9)
ECOG: Eastern Cooperative Oncology Group; PS: performance status; MGMT: O6-methylguanine-DNA-methyltransferase; IDH1: isocitrate
dehydrogenase 1; RT: radiation therapy; TMZ: temozolomide; CR: complete response; PR: partial response; SD: stable disease; PD: progressive
disease; CT: chemotherapy.

In our cases, 13 of 22 patients underwent second-line therapy after relapsing: of these, 1 patient received RT
plus TMZ, while 10 patients received chemotherapy alone (fotemustine in four PT, PCV/PC in four PT, and
TMZ in two PT) and 2 patients received RT alone; all of these patients had longer survival, with an OS of
30.7 months compared to 6.5 months for those who did not have second-line treatment (P = 0.04).

DISCUSSION
Gliomatosis cerebri is a rare entity, and it appears very difficult to define better management with multiple
studies attempting to investigate it. This work illustrates the real-life management of this disease from a
single institution, where the main goal was to deepen possible prognostic factors and treatment significance.