Combined modality therapy for intracranial tumors

Abstract

Three types of tumor (supratentorial astrocytoma, mednlloblastoma, and craniopharyngioma), each requiring a fundamentally different therapeutic approach, will be used to illustrate the principles and practice of combined treatment in this field. The role of radiotherapy and ways of enhancing the effect of irradiation will be considered. Attention will be given to adjuvant chemotherapy and to multiple drug regimes. Reference will he made to an early effort at immunotherapy following the initial reduction of tumor cell load by surgery and irradiation.Cancer 35: 1 1 1-120, 1975. N ASSESSING RESULTS OF TREATING CEREHRAI.

A randomized study of misonidazole and radiotherapy for grade 3 and 4 cerebral astrocytoma

“…There is no general agreement as to an optimum radiation dose and fractionation schedules for the treatment of gliomas. Conventionally, daily fractions of 1P8-2-0 Gy are given, to total doses of 45-65 Gy (Bloom, 1975;Salazar et al, 1979). The tissue volume treated also varies from that of the whole brain with or without a boost to the tumour, to smaller more restricted volumes throughout the entire treatment.…”

“…The median survival for patients treated by surgery alone is less than 6 months, and fewer than 500 survive at 3 years Bloom, 1975). Postoperative radiotherapy marginally improves the results (Roth & Elvidge, 1960;Taveras et al, 1962;Hitchcock & Sato, 1964;Jelsma & Bucy, 1967;.…”

Management of recurrent craniopharyngioma

“…4,6,32,[37][38][39][40][41] However, survival is a coarse measure of treatment effectiveness and it is essential to consider the role of the therapy in either controlling or causing the morbidities associated with this disease. Local control rates at 10 years in patients who received initial radiotherapy following surgery vary widely but have been reported at up to 100%, compared to 32% in those who did not receive initial radiation (p < 0.001).…”

Therapeutic benefits of combination chemotherapy with vincristine, BCNU, and procarbazine on recurrent cystic craniopharyngioma

“…Other forms of treatment, from a simple cyst aspiration to a subtotal resection, have frequently failed to prevent recurrence (5,6,(8)(9)(10)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Additional radiotherapy for residual or recurrent tumor has been recommended by some authors (9,11,(13)(14)(15)(16)(17)(18)(23)(24)(25)(26)(27)(28)(29)(30)(31). Intracystic isotopes have also been used in a few cases (32)(33)(34)(35)(36).…”