Management of high grade glioma

Management of high grade glioma

HIGH GRADE GLIOMAS

Anaplastic astrocytoma (WHO grade III)

Anaplastic oligodendroglioma (WHO III)

Anaplastic oligoastrocytoma (WHO grade III)

Glioblastoma multiforme (GBM) (WHO grade IV)

Malignant or high-grade gliomas account for approximately half of all primary brain tumors in adults

70% of all gliomas and predominantly affect patients between 40-70 years of age.

They are rapidly growing tumors that directly invade the brain parenchyma

They are commonly located in or near to eloquent brain regions, i.e. motor, language, visuo-spatial and memory.

These tumours continue to have growth potential, there is no stable tumour and recurrence tends to be at the site of the original disease

Death is usually due to recurrence and disease progression and the optimal treatment of HGG is tailored to individual patients

Clinical features

Features of raised intracranial pressure

focal neurological deficit are the commonest presenting complaint

PROGNOSIS

Due to their infiltrative nature high grade gliomas are not curable

Prognostic FactorsAge

tumor type

tumor grade

seizure symptoms

duration of symptoms

performance status

extent of surgery performed and irradiation dose

Using nonparametric recursive partitioning analysis (RPA)

a statistical tool that allows for the identification of significant prognostic factors and subsequent classification of patients into groups with similar outcomes

showed that age was the most important predictor of survival, with patients 70 more favorable than