There is no difference in survival between patients receiving standard RT or short-course RT. In view of the similar KPS scores, decreased increment in corticosteroid requirement, and reduced treatment time, the abbreviated course of RT seems to be a reasonable treatment option for older patients with GBM.
The presence of contrast enhancement in a brain tumor is often regarded as a sign of malignancy. The authors identified 314 patients with malignant and low-grade supratentorial glial neoplasms in an unselected population, 58 of which lacked contrast enhancement on preoperative neuroimaging. Nonenhancing gliomas were malignant in approximately one third of cases, especially in older patients. Histologic confirmation of the diagnosis is therefore important in all patients suspected of harboring a primary glial neoplasm.
Reovirus has potent activity against human malignant gliomas in vitro, in vivo, and ex vivo. Oncolysis with reovirus may be a potentially useful treatment for a broad range of human cancers.
In this clinical and histopathological study, the frequency of long‐term glioblastoma multiforme (GBM) survivors (LTGBMSs) was determined in a population‐based study. The Alberta Cancer Registry was used to identify all patients diagnosed with GBM in Alberta between January 1, 1975, and December 31, 1991. Patient charts were reviewed and histology reexamined. LTGBMSs were defined as GBM patients surviving 3 years after diagnosis. Each LTGBMS was compared with 3 age‐, sex‐, and year of diagnosis–matched controls, and patient/treatment or tumor characteristics that predicted long‐term survival were determined. There were 689 GBMs diagnosed in the study period; 15 (2.2%) of these patients survived 3 years. LTGBMSs (average age, 43.5 ± 3.3 years) were significantly younger when compared with all GBM patients (average age, 53.0 ± 0.56 years). LTGBMSs had a higher Karnofsky Performance Status score at diagnosis compared with controls. LTGBMSs were much more likely to have had a gross total resection and adjuvant chemotherapy than control GBM patients. Tumors from LTGBMSs tended to have fewer mitoses and a significantly lower Ki‐67 cellular proliferation index compared with controls. Radiation‐induced dementia was common and disabling in LTGBMSs. In conclusion, conventionally treated GBM patients in an unselected population have a very small chance of long‐term survival. The use of aggressive surgical resection and adjuvant chemotherapy may make long‐term survival more likely in GBM patients if their performance status is high at diagnosis. Ann Neurol 1999;47:183–188
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