scholarly journals Treatment Strategies for Malignant Gliomas-2006(Pathology and Treatment of Malignant Brain Tumors)

2006 ◽  
Vol 15 (10) ◽  
pp. 694-699
Author(s):  
Ryo Nishikawa
Keyword(s):  
Brain Tumors ◽  
Malignant Gliomas ◽  
Treatment Strategies ◽  
Special Issue ◽  
Malignant Brain Tumors

Cytostatic Agents in the Management of Malignant Gliomas

1998 ◽  
Vol 5 (2) ◽  
pp. 150-162 ◽  
Author(s):  
Tom Mikkelsen
Keyword(s):  
Signal Transduction ◽  
Brain Tumors ◽  
Tumor Invasion ◽  
Proteinase Inhibitors ◽  
Malignant Gliomas ◽  
Cytotoxic Agents ◽  
Management Approach ◽  
Cytostatic Agents ◽  
Management Options ◽  
Malignant Brain Tumors

Background: Cytotoxic therapy for malignant gliomas is limited by poor delivery and drug resistance, and local therapy is ineffective in managing migratory cells. However, recent developments in malignant glioma therapy involve trials of cytostatic rather than conventional cytotoxic agents. Methods: The biology of the brain extracellular matrix, tumor invasion, and angiogenesis are reviewed, and the cytostatic agents that inhibit matrix metalloproteinases, angiogenesis, cell proliferation, and signal transduction are discussed, as well as studies of the angiogenic and migratory capacity of malignant brain tumors. Results: Two specific and interrelated areas, anti-invasion (migration) and anti-angiogenesis, are potential areas to develop new treatment strategies. Tumor invasion and angiogenesis are important components of the spread and biologic effects of malignant gliomas. Several proteinase inhibitors are in clinical trial, as well as anti-angiogenic agents and signal transduction cascade inhibitors. Conclusions: Biologic control of brain tumor cell populations may offer a new management approach to add to currently available management options for malignant brain tumors.

scholarly journals Implantable Slow-Release Chemotherapeutic Polymers for the Treatment of Malignant Brain Tumors

1998 ◽  
Vol 5 (2) ◽  
pp. 130-137 ◽  
Author(s):  
Prakash Sampath ◽  
Henry Brem
Keyword(s):  
Brain Tumors ◽  
Slow Release ◽  
Malignant Gliomas ◽  
Polymer System ◽  
Chemotherapeutic Agents ◽  
Local Concentration ◽  
Malignant Brain Tumors ◽  
Polymeric Delivery ◽  
Double Blinded ◽  
Controlled Release Polymer

Background: Despite significant advances in neurosurgery, radiation therapy, and chemotherapy, the prognosis for patients with malignant brain tumors remains dismal. In an effort to improve control of local disease, we have developed a biodegradable, controlled-release polymer that is implanted directly at the tumor site. Methods: The preclinical and clinical development of the polymeric delivery of chemotherapeutic agents for treatment of patients with malignant gliomas is reviewed. Results: Carmustine (BCNU)-impregnated biodegradable polymer is the first new therapy approved by the FDA for patients with gliomas in 23 years. This delivery system provides high local concentration of drug with minimal systemic toxicity and obviates the need for drug to cross the blood-brain barrier. Randomized, multi-institutional, double-blinded, placebo-controlled studies have shown improved survival in patients treated for gliomas both at initial presentation and at recurrence. Several clinical principles have emerged from the use of this polymer system, and further applications are currently being investigated. Conclusions: Local delivery of therapeutic agents via biodegradable polymers may play an increasing role in patients with brain tumors.

Glioblastoma: Background, Standard Treatment Paradigms, and Supportive Care Considerations

2014 ◽  
Vol 42 (2) ◽  
pp. 171-182 ◽  
Author(s):  
Susan V. Ellor ◽  
Teri Ann Pagano-Young ◽  
Nicholas G. Avgeropoulos
Keyword(s):  
Central Nervous System ◽  
Brain Tumors ◽  
Standard Treatment ◽  
Malignant Gliomas ◽  
Survival Rates ◽  
Terminally Ill ◽  
Ethical Considerations ◽  
The Third ◽  
Malignant Brain Tumors ◽  
Median Survival Rate

While primary malignant brain tumors account for only two percent of all adult cancers, these neoplasms cause a disproportionate amount of cancer-related disabilities and death. The five-year survival rates for brain tumors are the third lowest among all types of cancer. Malignant gliomas (glioblastoma and anaplastic astrocytoma) comprise the most common types of primary central nervous system (CNS) tumors and have a combined incidence of five to eight cases per 100,000 people. The median survival rate of conservatively treated patients with malignant gliomas is 14 weeks; with surgical resection alone, 20 weeks; with surgery and radiation, 36 weeks; and with the addition of newer biochemotherapies such as temozolomide and bevacizumab, upward of 14-18 months.The profound cost of caring for terminally ill patients with primary malignant brain tumors raises ethical considerations for the American public; the stewardship of health care dollars for the population at large maintains a juxtaposed tension against a dynamic, necessary balance of hope, care, rehabilitation and research efforts for affected patients and their advocates.

Bevacizumab, a monoclonal antibody to the vascular endothelial growth factor (VEGF), and irinotecan for treatment of recurrent primary malignant brain tumors in adults

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 12503-12503 ◽  
Author(s):  
U. Lassen ◽  
K. Grunnet ◽  
M. Kosteljanetz ◽  
B. Hasselbalch ◽  
H. Laursen ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Tumor Regression ◽  
Malignant Gliomas ◽  
Complete Response ◽  
Consecutive Series ◽  
Topoisomerase 1 ◽  
Malignant Brain Tumors ◽  
Macdonald Criteria ◽  
Number Of Patients ◽  
Tumor Reduction

12503 Background: The prognosis of recurrent malignant brain tumors is poor, and no efficacious therapy exists in patients previously treated with radiotherapy and standard chemotherapy. Bevacizumab (B) binds to VEGF and inhibits tumor angiogenesis, and treatment with this drug might induce tumor regression and prolongation of life. Irinotecan (I) is a topoisomerase 1 inhibitor with modest effect on recurrent primary brain tumors. The combination of B and I in recurrent malignant gliomas was presented at ASCO 2006 and showed very encouraging responses. Methods: We report confirmatory results of the combination of B and I in a consecutive series of patients with primary malignant brain tumors recurring after standard primary and secondary treatment (surgery, radiotherapy and standard or secondline chemotherapy).With standard inclusion criteria, including PS 0–2, patients received B as 10mg/kg, and I 125 mg/m2 in patients not treated with enzyme inducing antiepileptic drugs (EIAED) or 340 mg/m2 in patients treated with EIAED every other week until progression or non-manageable toxicity. Response evaluation was performed by MacDonald criteria and MRI scans. Results: The results of 31 patients is presented, 15 with grade IV tumors (Glioblastoma multiforme), 7 with grade III anaplastic astrocytomas, 5 with anaplastic oligodendrogliomas, 1 with anaplastic ependymoma, 1 with hemangiopericytoma, 1 with prolactinoma, and 1 with medulloblastoma. Four patients had complete response, 3 grade IV tumors and 1 anaplastic oligodendroglioma. One patient had partial response (> 50% tumor reduction), 12 had stable disease (3 had tumor reduction between 31 - 45 %). 14 progressed. No grade 4 toxicity was observed and most patients experienced grade 1–2 toxicity. Two tromboembolic events and 1 intestinal perforation were observed. Conclusion: The combination of B and I is safe, induces tumor regression in a substantial number of patients, and can be used as treatment to patients recurring after standard treatment. No significant financial relationships to disclose.

scholarly journals Treatment strategies for medulloblastoma and primitive neuroectodermal tumors

1999 ◽  
Vol 7 (2) ◽  
pp. E3 ◽  
Author(s):  
Deborah R. Gold ◽  
Roger J. Packer ◽  
Bruce H. Cohen
Keyword(s):  
Brain Tumors ◽  
Standard Dose ◽  
Treatment Strategies ◽  
Disease Free Survival ◽  
Primary Treatment ◽  
Primitive Neuroectodermal Tumors ◽  
Reduced Dose ◽  
Malignant Brain Tumors ◽  
Neuroectodermal Tumors ◽  
Radiotherapy Alone

Medulloblastoma and primitive neuroectodermal tumors (PNETs) are the most common malignant brain tumors in children. The concern for late sequelae of neuraxis irradiation and the obligation to improve disease-free survival in children who harbor malignant brain tumors has led to the additional provision of systemic chemotherapy to standard- and reduced-dose radiotherapy, as well as to the evaluation of alternate modes of radiotherapy delivery. Analysis of evidence has suggested that chemotherapy has an impact on length of survival in children with medulloblastoma and PNETs. The question remains as to whether chemotherapy combined with reduced-dose radiotherapy provides greater benefit than standard-dose radiotherapy alone, and which subset of children the treatment most benefits. Also unanswered is the question of whether chemotherapy can serve as the primary treatment in infants with these lesions. In an attempt to help answer these questions, the authors review the major chemotherapy and radiotherapy trials for newly diagnosed patients and those with recurrent medulloblastoma and PNETs.

scholarly journals Epidemiological features of brain tumors

2013 ◽  
Vol 141 (11-12) ◽  
pp. 823-829 ◽  
Author(s):  
Nenad Zivkovic ◽  
Goran Mihailovic ◽  
Marko Markovic ◽  
Iva Berisavac ◽  
Milan Spaic
Keyword(s):  
Risk Factor ◽  
Brain Tumor ◽  
Brain Tumors ◽  
Western Europe ◽  
Malignant Tumors ◽  
Tumor Development ◽  
Treatment Strategies ◽  
Developed Countries ◽  
Efficient Treatment ◽  
Malignant Brain Tumors

Brain tumors account for 1.4% of all cancers and 2.4% of all cancer-related deaths. The incidence of brain tumors varies and it is higher in developed countries of Western Europe, North America, Australia and New Zealand. In Serbia, according to data from 2009, malignant brain tumors account for 2. 2 of all tumors, and from all cancer?related deaths, 3.2% is caused by malignant brain tumors. According to recent statistical reports, an overall incidence of brain tumors for benign and malignant tumors combined is 18.71 per 100,000 persons/year. The most common benign brain tumor in adults is meningioma, which is most present in women, and the most common malignant tumor is glioblastoma, which is most present in adult men. Due to high mortality, especially in patients diagnosed with glioblastoma and significant brain tumor morbidity, there is a constant interest in understanding its etiology in order to possibly prevent tumor occurrence in future and enable more efficient treatment strategies for this fatal brain disease. Despite the continuously growing number of epidemiological studies on possible factors of tumor incidence, the etiology remains unclear. The only established environmental risk factor of gliomas is ionizing radiation exposure. Exposure to radiofrequency electromagnetic fields via cell phone use has gained a lot of attention as a potential risk factor of brain tumor development. However, studies have been inconsistent and inconclusive, so more definite results are still expected.

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