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ORIGINAL ARTICLE
Year : 2009  |  Volume : 5  |  Issue : 9  |  Page : 44-47

Differential responses of tumors and normal brain to the combined treatment of 2-DG and radiation in glioablastoma


1 Manipal Institute for Neurological Disorders, Bangalore, India
2 Advanced Neuroscience Institute, BGS Global Hospital, Bangalore, India
3 Institute of Nuclear Medicine and Allied Sciences, New Delhi, India
4 National Institute of Mental Health and Neurosciences, Bangalore, India

Correspondence Address:
B S Dwarakanath
Institute of Nuclear Medicine and Allied Sciences, New Delhi 110 054
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-1482.55141

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2-deoxy-D-glucose (2-DG), an inhibitor of glucose transport and glycolysis, enhances radiation damage selectively in tumor cells by modulating damage response pathways resulting in cell death in vitro and local tumor control. Phase I and II clinical trials in patients with malignant glioma have shown excellent tolerance to a combined treatment of orally administered 2-DG and hypofractionated radiotherapy without any acute toxicity and late radiation damage. Phase III efficacy trials are currently at an advanced stage. Re-exploratory surgery performed in 13 patients due to persistent symptoms of elevated ICP and mass effect at different follow-up periods revealed extensive tumor necrosis with well-preserved normal brain tissue adjoining the tumor included in the treatment volume as revealed by a histological examination. These observations are perhaps the first clinical evidences for differential effects of 2-DG on tumors and normal tissues in conformity with earlier in vitro and in vivo studies in normal and tumor-bearing mice.


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