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