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Tumors of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
The initial treatment for malignant glioma is surgical resection. Biopsy alone should be reserved for patients with glioma in very eloquent brain or those deemed too medically frail to tolerate a more extensive resection. Aggressive surgical resection offers several advantages over biopsy: Improved survival, particularly in younger patients with better performance status.More accurate diagnosis due to a larger, more representative sample.Debulking of the tumor often produces symptomatic improvement and allows more rapid tapering of corticosteroids (with reduced corticosteroid adverse effects).Smaller tumor volumes may improve the response to postoperative adjuvant therapies.
High-grade Glioma
Published in David A. Walker, Giorgio Perilongo, Roger E. Taylor, Ian F. Pollack, Brain and Spinal Tumors of Childhood, 2020
Donald C. Macarthur, Christof M. Kramm, Matthias A. Karajannis
If there is significant hydrocephalus with a deeply located tumor, CSF diversion by temporary external ventricular drain or more permanent endoscopic third ventriculostomy or ventriculoperitoneal shunting may be required as a first step. More often the priority in surgery is with obtaining a tissue diagnosis and with achieving as complete a surgical resection as is safely possible. Outcome in adult malignant glioma is determined by age, Karnofsky performance status, and molecular characteristics of the tumor and there has been ongoing debate for many years over the importance of extent of resection as an independent factor influencing outcome.51 In contrast pediatric studies in HGG have more consistently shown an advantage to more extensive resections.
Bispecific Antibodies
Published in Siegfried Matzku, Rolf A. Stahel, Antibodies in Diagnosis and Therapy, 2019
David M. Segal, Barbara A. Vance, Giuseppe Sconocchia
A hetero-F(ab’)2 with anti-CD3 and anti-glioma specificities was the first bsAb used to treat cancer patients (Nitta et al., 1990). The study was carried out with 20 patients having grade III/IV malignant glioma. Taking advantage of the local growth of glioma, the investigators infused autologous PBMC, previously activated for 7-10 days with IL-2 in the presence (ten patients) or absence (ten patients) of bsAb, into the tumor site by an Ommaya reservoir that had been positioned during surgical removal of the glioma. The treatment regimen consisted of three bi-weekly infusions over a three week period. In the group of patients treated with the bsAb none relapsed in a 10-18 month follow-up period. CT scans and histological examination confirmed the clinical outcomes, showing eradication of residual glioma in four patients and tumor regression in four others. By contrast, in the group treated with autologous activated PBMC in the absence of bsAb, only two patients were alive after 2 years.
DNA polymerase ζ suppresses the radiosensitivity of glioma cells by regulating the PI3K/AKT/mTOR pathway
Published in Autoimmunity, 2023
Jiqiang Ding, Zhisheng Chen, Weilong Ding, Yongsheng Xiang, Junbao Yang
Glioma is a central nervous system (CNS) tumor in adults with significant incidence and mortality. It can be classified as adult-type diffuse gliomas, pediatric-type diffuse low-grade gliomas, pediatric-type diffuse high-grade gliomas, and circumscribed astrocytic gliomas, accounting for 1/4 of all primary CNS tumors [1]. The prognosis of glioblastoma (GBM) is poor, with a median survival rate of 14 months [2]. Treatment options for malignant glioma have major limitations. Like most cancers, the standard treatments of glioma include surgery and chemoradiotherapy [3]. However, radiation resistance is a major obstacle to the success of radiotherapy [4]. Therefore, exploring appropriate methods to enhance the sensitivity of radiotherapy may be helpful to improve the clinical outcomes of glioma.
Investigation of the Relationship between CMYC Gene Polymorphisms and Glioma Susceptibility in Chinese Children
Published in Cancer Investigation, 2021
Susu Lou, Xiaokai Huang, Xiaoqian Tian, Zhen Wang, Ao Lin, Hanqi Dai, Jingying Zhou, Jichen Ruan, Li Yuan, Juxiang Wang
Glioma is an intracranial tumor that originates from glial cells, and one of the most common malignant tumors in children, accounting for 45%–55% of pediatric intracranial tumors (1,2). The overall annual incidence of glioma is 3–8 per 100000, and varies according to glioma subtype, among which astrocytoma is the most common, accounting for 17.4%, with ependymoma accounting for 10.2%, and oligodendroglioma for 5.8%. Treatment and prognosis also differ according to glioma subtype (3). At present, the primary treatment for glioma is surgical resection, usually combined with radiotherapy and chemotherapy (4,5). In recent years, there has been remarkable progress in glioma diagnosis, imaging, radiotherapy, chemotherapy, and neurosurgery; however, because of high rates of tumor recurrence, the poor prognosis of patients with malignant glioma has not been substantially improved (6,7). The median survival time of patients with glioblastoma is less than 14 months, and the one-year cumulative survival rate is less than 30% (8,9).
FOXG1 mediates the radiosensitivity of glioma cells through regulation of autophagy
Published in International Journal of Radiation Biology, 2021
Ning Xiao, Churong Li, Wenjun Liao, Jun Yin, Shichuan Zhang, Peng Zhang, Lan Yuan, Min Hong
Glioma, also known as brain glioma, accounts for 50–55% of primary nervous system tumors and is an aggressive form of brain cancer (Goodenberger and Jenkins 2012). Despite therapeutic advances in diagnosis and clinical treatment, the prognosis remains poor and the median survival time after diagnosis of malignant glioma is less than 15 months (deSouza et al. 2016). Surgery, radiotherapy or chemotherapy is introduced when oncology is certified. Due to its anatomical position, glioma can be difficult to completely remove; therefore, postoperative radiotherapy and chemotherapy are necessary. Radiotherapy is usually conducted for high-grade glioma patients once surgeries had been introduced to these patients and it is also appropriate for some patients who are not eligible for surgeries (Qi et al. 2016). The study has shown that the patients who received postoperative radiotherapy had markedly improved 5-year overall and progression-free survival rates (Liu et al. 2018). However, gliomas exhibit resistance to radiotherapy; thus, strategies to effectively improve the radio-sensitivity of tumors and increase the postoperative survival rates of patients are of prominent focus in radiation oncology.