Gliomatosis cerebri medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
The predominant therapy for gliomatosis cerebri is [[surgical resection]]. Adjunctive [[chemotherapy]] and [[radiation]] may be required. Supportive therapy for gliomatosis cerebri includes [[anticonvulsants]] and [[corticosteroids]]. | The predominant therapy for gliomatosis cerebri is [[surgical resection]]. Adjunctive [[chemotherapy]] and [[radiation]] may be required.<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> 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> | ||
==Medical Therapy== | ==Medical Therapy== | ||
The predominant therapy for gliomatosis cerebri is [[surgical resection]]. Adjunctive [[chemotherapy]] and [[radiation]] may be required. Supportive therapy for gliomatosis cerebri includes [[anticonvulsants]] and [[corticosteroids]]. | The predominant therapy for gliomatosis cerebri is [[surgical resection]]. Adjunctive [[chemotherapy]] and [[radiation]] may be required.<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> 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=== | ===Radiotherapy=== | ||
Revision as of 15:08, 30 September 2015
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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] Supportive therapy for gliomatosis cerebri includes anticonvulsants and corticosteroids.[3]
Medical Therapy
The predominant therapy for gliomatosis cerebri is surgical resection. Adjunctive chemotherapy and radiation may be required.[1][2] Supportive therapy for gliomatosis cerebri includes anticonvulsants and corticosteroids.[3]
Radiotherapy
- Post-operative radiotherapy is recommended among all patients who develop gliomatosis cerebri.
- Radiotherapy may not cure the cancer, but can control the tumor and delay recurrence.
- Targeted three-dimensional conformal radiotherapy is preferred to whole brain radiotherapy.
- The median dose of radiation is 60 Gy (range: 50-72 Gy).[4]
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.[1]
- 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.[5]
- Other chemotherapeutic drugs that may be used for the treatment of gliomatosis cerebri include:[2]
Supportive treatment
- Supportive therapy for gliomatosis cerebri includes anticonvulsants and corticosteroids, which focuses on relieving symptoms and improving the patient’s neurologic function.[3]
- 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 Sanson M, Napolitano M, Cartalat-Carel S, Taillibert S (2005). "[Gliomatosis cerebri]". Rev Neurol (Paris). 161 (2): 173–81. PMID 15798516.
- ↑ 2.0 2.1 2.2 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.
- ↑ 3.0 3.1 3.2 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.
- ↑ 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.
- ↑ 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.