Prognostic Factors for Malignant Glioma

Byar, David P.; Green, Sylvan B.; Strike, Thomas A.

doi:10.1007/978-1-4613-3858-1_14

Cited by 45 publications

(14 citation statements)

References 15 publications

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“…Among the explanations for this association are the rela tive surgical accessibility of the cortical tumors, earlier detection and diagnosis as a result of early seizure activity and also the higher frequency of low-grade tumor types in this population [34,36]. In our series, cortical involve ment of tumor in general was not significantly associated with long survival.…”

Section: Discussionmentioning

confidence: 46%

Seizures in Children with Supratentorial Astroglial Neoplasms

Shady¹,

Black²,

Kupsky

et al. 1994

Pediatr Neurosurg

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We reviewed the records of 98 consecutive patients, 18 years of age or younger, with pathologically confirmed supratentorial astroglial neoplasms at the Children’s Hospital, Boston, to evaluate the importance of seizures in their presentation and natural history. Tumors were diagnosed using the WHO criteria as pilocytic astrocytomas, astrocytomas, anaplastic astrocytomas, glioblastomas, giant cell glioblastomas, oligoastrocytomas and gangliogliomas. Our results were as follows. (1) Fifty percent of children had seizures as part of their presentation and 30% had seizures as their only presenting phenomenon. The seizures varied in nature, but complex (55%) or simple (28%) partial seizures were by far the most common types, occurring in 77% of cases. Preoperative electroencephalography (EEG) accurately lateralized to the tumor side in 88% of the cases and localized to the correct lobe in 56%.Tumors involving cerebral cortex significantly correlated with seizures at presentation as compared to noncortical locations; 59% of patients with cortical tumors presented with seizures, and only 15% of patients with noncortical tumors experienced seizures. Lesions in the temporal and frontal lobes had the highest incidence of seizures. Patients with gangliogliomas and oligoastrocytomas had the highest incidence of seizures, 88 and 86%, respectively, whereas patients with anaplastic astrocytoma had the lowest incidence, 21%. Histopathologic calcification was associated with seizures at presentation approaching significance (p = 0.06). Seizures at presentation were significantly associated with good prognosis (p = 0.02).

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Section: Discussionmentioning

confidence: 46%

Seizures in Children with Supratentorial Astroglial Neoplasms

Shady¹,

Black²,

Kupsky

et al. 1994

Pediatr Neurosurg

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“…From our data it is also apparent that within the tested groups (A + B), fewer parietal tumours are sensitive in vitro (Table II), and this results in an overall poorer prognosis for patients with parietal tumours in the group as a whole. A detailed examination of the Brain Tumor Study Group data has failed to confirm that patients with parietal tumours have a worse prognosis than patients with tumours in other locations (Byar et al, 1983).…”

Section: Discussionmentioning

confidence: 99%

Assay of anti-cancer drugs in tissue culture: Relationship of relapse free interval (RFI) and in vitro chemosensitivity in patients with malignant cerebral glioma

Thomas¹,

Darling²,

Paul³

et al. 1985

Br J Cancer

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Summary One hundred and seventeen patients with cerebral glioma (Kernohan grades III and IV) were treated with adjuvant chemotherapy using procarbazine (PCB), CCNU and vincristine (VCR) following whole head irradiation. Cell cultures were prepared from 40 patients in this series and their sensitivity to each cytotoxic drug was assessed in a mictotitration assay with 35 S-methionine incorporation as the end point. Twenty-two of forty (55%) patients responded to PCB and/or CCNU in vitro, and sensitivity to these drugs was linked with increased RFI, whilst sensitivity to VCR was not. The RFI of patients who had responded to PCB or CCNU in vitro was significantly longer than the RFI of patients whose tumours failed to respond in vitro or patients who had not been tested. There was no difference in sex ratio, extent of operation, radiation dose and degree of steroid cover between responders, non-responders and untested groups. Grade III tumours tended to be more sensitive in vitro than grade IV tumours. The age of patients also influenced in vitro chemosensitivity. Patients with chemosensitive tumours in vitro tended to be younger than patients with insensitive tumours in vitro. Further statistical analysis, taking into account these prognostic factors, indicated an association between chemosensitivity in vitro and RFI.

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“…The malignant glioma carries an extremely poor prognosis particularly in the older patients and in patients with a poor performance status and the standard 6 week course of post-operative radiotherapy is disproportionately long, given their poor prognosis for survival [11][12][13]. There is therefore a need to improve the survival-treatment time ratio by decreasing the standard treatment time and also a need to find a way to select out those patients who will benefit from radiation.…”

Section: Discussionmentioning

confidence: 99%

Pre-radiation chemotherapy in glioma patients with poor prognostic factors

et al. 1992

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Nineteen patients in an age group from 56-67 years (mean age 62.5 years) with histologically verified glioblastoma multiforme were treated with chemotherapy consisting of two cycles of oral CCNU, intravenous vincristine and oral procarbazine prior to radiation therapy. Ten of the patients had stable disease, monitored by CT scan and neurological examination, and received whole brain radiation. The median survival was 12 months. Nine patients who had progressive disease during chemotherapy did not receive radiation treatment and were put on palliative treatment with dexamethasone. This group had a median survival of 3 months. The median survival in all of the 19 patients who entered the study was 9 months which was comparable to the survival of 56 patients with glioblastoma multiforme who, in a retrospective study, received post-operative radiotherapy. The most important factor predicting survival was steroid-dependency after surgery.

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Prognostic Factors for Malignant Glioma

Cited by 45 publications

References 15 publications

Seizures in Children with Supratentorial Astroglial Neoplasms

Seizures in Children with Supratentorial Astroglial Neoplasms

Assay of anti-cancer drugs in tissue culture: Relationship of relapse free interval (RFI) and in vitro chemosensitivity in patients with malignant cerebral glioma

Pre-radiation chemotherapy in glioma patients with poor prognostic factors

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