Gliomatosis cerebri medical therapy: Difference between revisions
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The predominant therapy for gliomatosis cerebri is [[surgical resection]]. Adjunctive [[chemotherapy]] and [[radiation]] may be required.<ref name="pmid21301914">{{cite journal| author=Inoue T, Kumabe T, Kanamori M, Sonoda Y, Watanabe M, Tominaga T| title=Prognostic factors for patients with gliomatosis cerebri: retrospective analysis of 17 consecutive cases. | journal=Neurosurg Rev | year= 2010 | volume= 34 | issue= 2 | pages= 197-208 | pmid=21301914 | doi=10.1007/s10143-010-0306-1 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21301914 }} </ref><ref name="pmid15798516">{{cite journal| author=Sanson M, Napolitano M, Cartalat-Carel S, Taillibert S| title=[Gliomatosis cerebri]. | journal=Rev Neurol (Paris) | year= 2005 | volume= 161 | issue= 2 | pages= 173-81 | pmid=15798516 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15798516 }} </ref><ref name="pmid12325066">{{cite journal| author=Herrlinger U, Felsberg J, Küker W, Bornemann A, Plasswilm L, Knobbe CB et al.| title=Gliomatosis cerebri: molecular pathology and clinical course. | journal=Ann Neurol | year= 2002 | volume= 52 | issue= 4 | pages= 390-9 | pmid=12325066 | doi=10.1002/ana.10297 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12325066 }} </ref><ref name="pmid7407756">{{cite journal| author=Levin VA, Edwards MS, Wright DC, Seager ML, Schimberg TP, Townsend JJ et al.| title=Modified procarbazine, CCNU, and vincristine (PCV 3) combination chemotherapy in the treatment of malignant brain tumors. | journal=Cancer Treat Rep | year= 1980 | volume= 64 | issue= 2-3 | pages= 237-44 | pmid=7407756 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7407756 }} </ref> Supportive therapy for gliomatosis cerebri includes [[anticonvulsants]] and [[corticosteroids]].<ref name="pmid22740882">{{cite journal| author=Rajz GG, Nass D, Talianski E, Pfeffer R, Spiegelmann R, Cohen ZR| title=Presentation patterns and outcome of gliomatosis cerebri. | journal=Oncol Lett | year= 2012 | volume= 3 | issue= 1 | pages= 209-213 | pmid=22740882 | doi=10.3892/ol.2011.445 | pmc=PMC3362440 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22740882 }} </ref> | The predominant therapy for gliomatosis cerebri is [[surgical resection]]. Adjunctive [[chemotherapy]] and [[radiation]] may be required.<ref name="pmid21301914">{{cite journal| author=Inoue T, Kumabe T, Kanamori M, Sonoda Y, Watanabe M, Tominaga T| title=Prognostic factors for patients with gliomatosis cerebri: retrospective analysis of 17 consecutive cases. | journal=Neurosurg Rev | year= 2010 | volume= 34 | issue= 2 | pages= 197-208 | pmid=21301914 | doi=10.1007/s10143-010-0306-1 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21301914 }} </ref><ref name="pmid15798516">{{cite journal| author=Sanson M, Napolitano M, Cartalat-Carel S, Taillibert S| title=[Gliomatosis cerebri]. | journal=Rev Neurol (Paris) | year= 2005 | volume= 161 | issue= 2 | pages= 173-81 | pmid=15798516 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15798516 }} </ref><ref name="pmid12325066">{{cite journal| author=Herrlinger U, Felsberg J, Küker W, Bornemann A, Plasswilm L, Knobbe CB et al.| title=Gliomatosis cerebri: molecular pathology and clinical course. | journal=Ann Neurol | year= 2002 | volume= 52 | issue= 4 | pages= 390-9 | pmid=12325066 | doi=10.1002/ana.10297 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12325066 }} </ref><ref name="pmid7407756">{{cite journal| author=Levin VA, Edwards MS, Wright DC, Seager ML, Schimberg TP, Townsend JJ et al.| title=Modified procarbazine, CCNU, and vincristine (PCV 3) combination chemotherapy in the treatment of malignant brain tumors. | journal=Cancer Treat Rep | year= 1980 | volume= 64 | issue= 2-3 | pages= 237-44 | pmid=7407756 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7407756 }} </ref> Supportive therapy for gliomatosis cerebri includes [[anticonvulsants]] and [[corticosteroids]].<ref name="pmid22740882">{{cite journal| author=Rajz GG, Nass D, Talianski E, Pfeffer R, Spiegelmann R, Cohen ZR| title=Presentation patterns and outcome of gliomatosis cerebri. | journal=Oncol Lett | year= 2012 | volume= 3 | issue= 1 | pages= 209-213 | pmid=22740882 | doi=10.3892/ol.2011.445 | pmc=PMC3362440 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22740882 }} </ref> | ||
===Radiotherapy=== | ===1. Radiotherapy=== | ||
*[[Radiation|Post-operative radiotherapy]] is recommended among all patients who develop gliomatosis cerebri. | *[[Radiation|Post-operative radiotherapy]] is recommended among all patients who develop gliomatosis cerebri. | ||
*Radiotherapy may not cure the cancer but can control the tumor, delay recurrence, and increase survival. | *Radiotherapy may not cure the cancer but can control the tumor, delay recurrence, and increase survival. | ||
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*The median dose of radiation is 60 Gy (range: 50-72 Gy).<ref name="pmid21301914">{{cite journal| author=Inoue T, Kumabe T, Kanamori M, Sonoda Y, Watanabe M, Tominaga T| title=Prognostic factors for patients with gliomatosis cerebri: retrospective analysis of 17 consecutive cases. | journal=Neurosurg Rev | year= 2010 | volume= 34 | issue= 2 | pages= 197-208 | pmid=21301914 | doi=10.1007/s10143-010-0306-1 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21301914 }} </ref> | *The median dose of radiation is 60 Gy (range: 50-72 Gy).<ref name="pmid21301914">{{cite journal| author=Inoue T, Kumabe T, Kanamori M, Sonoda Y, Watanabe M, Tominaga T| title=Prognostic factors for patients with gliomatosis cerebri: retrospective analysis of 17 consecutive cases. | journal=Neurosurg Rev | year= 2010 | volume= 34 | issue= 2 | pages= 197-208 | pmid=21301914 | doi=10.1007/s10143-010-0306-1 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21301914 }} </ref> | ||
===Chemotherapy=== | ===2. Chemotherapy=== | ||
*[[Chemotherapy]] is indicated as adjuvant therapy for gliomatosis cerebri. | *[[Chemotherapy]] is indicated as adjuvant therapy for gliomatosis cerebri. | ||
*[[Temozolomide]] ([[Temodar]]) is the preferred drug for the treatment of high-grade gliomatosis cerebri. | *[[Temozolomide]] ([[Temodar]]) is the preferred drug for the treatment of high-grade gliomatosis cerebri. | ||
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**[[Erlotinib]] | **[[Erlotinib]] | ||
===Supportive treatment=== | ===3. Supportive treatment=== | ||
*Supportive therapy for gliomatosis cerebri includes [[anticonvulsants]] and [[corticosteroids]], which focuses on relieving symptoms and improving the patient’s neurologic function.<ref name="pmid22740882">{{cite journal| author=Rajz GG, Nass D, Talianski E, Pfeffer R, Spiegelmann R, Cohen ZR| title=Presentation patterns and outcome of gliomatosis cerebri. | journal=Oncol Lett | year= 2012 | volume= 3 | issue= 1 | pages= 209-213 | pmid=22740882 | doi=10.3892/ol.2011.445 | pmc=PMC3362440 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22740882 }} </ref> | *Supportive therapy for gliomatosis cerebri includes [[anticonvulsants]] and [[corticosteroids]], which focuses on relieving symptoms and improving the patient’s neurologic function.<ref name="pmid22740882">{{cite journal| author=Rajz GG, Nass D, Talianski E, Pfeffer R, Spiegelmann R, Cohen ZR| title=Presentation patterns and outcome of gliomatosis cerebri. | journal=Oncol Lett | year= 2012 | volume= 3 | issue= 1 | pages= 209-213 | pmid=22740882 | doi=10.3892/ol.2011.445 | pmc=PMC3362440 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22740882 }} </ref> | ||
**[[Anticonvulsants]] are administered to the patients who have a [[seizure]]. [[Phenytoin]] given concurrently with [[radiation]] may have serious skin reactions such as [[erythema multiforme]] and [[Stevens-Johnson syndrome]]. | **[[Anticonvulsants]] are administered to the patients who have a [[seizure]]. [[Phenytoin]] given concurrently with [[radiation]] may have serious skin reactions such as [[erythema multiforme]] and [[Stevens-Johnson syndrome]]. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]
Overview
The predominant therapy for gliomatosis cerebri is surgical resection. Adjunctive chemotherapy and radiation may be required.[1][2][3][4] Supportive therapy for gliomatosis cerebri includes anticonvulsants and corticosteroids.[5]
Medical Therapy
The predominant therapy for gliomatosis cerebri is surgical resection. Adjunctive chemotherapy and radiation may be required.[1][2][3][4] Supportive therapy for gliomatosis cerebri includes anticonvulsants and corticosteroids.[5]
1. Radiotherapy
- Post-operative radiotherapy is recommended among all patients who develop gliomatosis cerebri.
- Radiotherapy may not cure the cancer but can control the tumor, delay recurrence, and increase survival.
- Targeted three-dimensional conformal radiotherapy is preferred to whole brain radiotherapy.
- The median dose of radiation is 60 Gy (range: 50-72 Gy).[1]
2. Chemotherapy
- Chemotherapy is indicated as adjuvant therapy for gliomatosis cerebri.
- Temozolomide (Temodar) is the preferred drug for the treatment of high-grade gliomatosis cerebri.
- Procarbazine-CCNU-Vincristine is the preferred drug regimen for slow growing, low-grade gliomatosis cerebri.[2]
- CCNU is administered on day 1, procarbazine is administered daily for 14 days beginning on day 8, and vincristine is administered on days 8 and 29 of each 6-week cycle of therapy.[4]
- Other chemotherapeutic drugs that may be used for the treatment of gliomatosis cerebri include:[3]
3. Supportive treatment
- Supportive therapy for gliomatosis cerebri includes anticonvulsants and corticosteroids, which focuses on relieving symptoms and improving the patient’s neurologic function.[5]
- Anticonvulsants are administered to the patients who have a seizure. Phenytoin given concurrently with radiation may have serious skin reactions such as erythema multiforme and Stevens-Johnson syndrome.
- Corticosteroids, usually dexamethasone given 4-10 mg every 4-6 h, can reduce peritumoral edema, diminish mass effect, and lower intracranial pressure with a decrease in headache or drowsiness.
References
- ↑ 1.0 1.1 1.2 Inoue T, Kumabe T, Kanamori M, Sonoda Y, Watanabe M, Tominaga T (2010). "Prognostic factors for patients with gliomatosis cerebri: retrospective analysis of 17 consecutive cases". Neurosurg Rev. 34 (2): 197–208. doi:10.1007/s10143-010-0306-1. PMID 21301914.
- ↑ 2.0 2.1 2.2 Sanson M, Napolitano M, Cartalat-Carel S, Taillibert S (2005). "[Gliomatosis cerebri]". Rev Neurol (Paris). 161 (2): 173–81. PMID 15798516.
- ↑ 3.0 3.1 3.2 Herrlinger U, Felsberg J, Küker W, Bornemann A, Plasswilm L, Knobbe CB; et al. (2002). "Gliomatosis cerebri: molecular pathology and clinical course". Ann Neurol. 52 (4): 390–9. doi:10.1002/ana.10297. PMID 12325066.
- ↑ 4.0 4.1 4.2 Levin VA, Edwards MS, Wright DC, Seager ML, Schimberg TP, Townsend JJ; et al. (1980). "Modified procarbazine, CCNU, and vincristine (PCV 3) combination chemotherapy in the treatment of malignant brain tumors". Cancer Treat Rep. 64 (2–3): 237–44. PMID 7407756.
- ↑ 5.0 5.1 5.2 Rajz GG, Nass D, Talianski E, Pfeffer R, Spiegelmann R, Cohen ZR (2012). "Presentation patterns and outcome of gliomatosis cerebri". Oncol Lett. 3 (1): 209–213. doi:10.3892/ol.2011.445. PMC 3362440. PMID 22740882.