MGMT Methylation And EGFR Expression Detection Guided Treatment For Malignant Gliomas

Objective:According to the test results which MGMT gene promoter methylation and EGFR expression of30patients with malignant glioma tumor tissue after surgery, developed individualized treatment plan and associated radiation therapy, chemotherapy, and observed treatment of giving individual treatmentefficacy after one month.Methods:Collected from January2012to January2014period, Shenyang Military Region General Hospital neurosurgery accepted surgical treatment, and were confirmed by pathology according to the2007edition of WHO classification of tumors of the central nervous system in patients with malignant brain gliomas(WHO gradeⅢ, WHO gradeⅣ) diagnosed30cases tumor tissue (anaplastic oligodendroglioma (WHO gradeⅢ) two cases, anaplastic oligoastrocytoma (WHO gradeⅢ)6cases, anaplastic astrocytoma (WHO gradeⅢ)10cases, glioblastoma (WHO gradeIV)12cases). Methylation specific PCR (MSP) on30cases of patients with malignant brain glioma tumor tissue O6-methylguanine-DNA methyltransferase (MGMT) gene promoter detecting the methylation status and immunohistochemical S-P method on30patients with malignant glioma brain tumor tissue after surgery detected Epidermal Growth Factor Receptor (EGFR) expression levels. Based on test results develop individualized treatment plan of30cases of malignant glioma patients. MGMT gene promoter unmethylated anaplastic oligodendroglioma (WHO gradeⅢ), anaplastic oligoastrocytoma (WHO gradeⅢ), anaplastic astrocytoma (WHO gradeⅢ) and EGFR expression into (-or1+) in patients taking postoperative radiotherapy alone; MGMT gene promoter unmethylated anaplastic oligodendroglioma (WHO gradeⅢ), anaplastic oligoastrocytoma (WHO gradeⅢ), anaplastic astrocytoma (WHO gradeⅢ) and EGFR expression into (2+or3+) in patients taking temozolomide and concurrent chemoradiotherapy; MGMT gene promoter methylated anaplastic oligodendroglioma (WHO gradeⅢ), anaplastic oligoastrocytoma (WHO gradeⅢ), anaplastic astrocytoma (WHO gradeⅢ) in patients taking temozolomide and concurrent chemoradiotherapy; Patients with glioblastomapostoperative adopt a uniform line temozolomide concurrent chemoradiotherapy and then take six cycles of adjuvant chemotherapy with temozolomide. After treatment, referring to the2009RECIST criteria assessed30cases of malignant glioma patients given month individualized treatment efficacy.Results:On the basis of the detection result which postoperative tumor MGMT gene promoter methylation and expression of EGFR,30cases of malignant brain glioma patients individualized treatment a month, according to RECIST evaluation criteria,12cases of complete remission (56.67%),17cases of partial remission (40.00%),0case of stable disease,1case of disease progression (3.33%), efficiency96.67%, disease control rate96.67%.Conclusion:A guide which individualized clinical treatment of malignant glioma patients through the MGMT gene promoter methylation and expression of EGFR test results, can get better treatment in the short term.