Glioma

Description:

Glioma - the tumor which is entering into heterogeneous group and having a neuroectodermal origin. A glioma - the most widespread primary tumor of a brain. Gliomas differ on zlokachestvennost degree, histologic signs, age of manifestation, ability to an invasion and tumoral progress, etc.

Glioma symptoms:

Symptoms of a glioma depend on localization of a tumor in a brain, and also on a stage. Usual symptoms include: headaches, eileptichesky attacks, difficulties with the speech, weakness/paralysis of one part of a body or person, deterioration in sight, deterioration in feelings, balance disturbance, nausea/vomiting, changes in behavior, memory impairment and thinking. Disease of not treated malignant glioma is characterized by constant invasive growth, and even in case of treatment, almost universal recuring.

Glioma reasons:

The question of cells predecessors of gliomas still is a subject of discussions. Classically it is considered that astrocytomas develop from an astrocytic sprout, and an oligodendroglioma from an oligodendroglialny sprout. However a number of modern researchers considers that existence of "windows of malignant vulnerability" (window of neoplastic vulnerability) is the cornerstone of an origin of gliomas, that is gliomas develop not from mature cells of a glia (astrocytes and oligodendrocytes), and from slowly proliferating cells (still-proliferating cells) in which there is a malignant regeneration. And the direction of a tumoral progression (an astrocytoma or an oligodendroglioma) is defined by existence of various genetic disorders. So, for example, the main genetic breakdown defining an astrocytic way of development is damage to TP53 gene, losses of heterozygosity in loci 1p and 19q are characteristic of oligodendrogliomas.

Treatment of the Glioma:

Traditional options of treatment of malignant gliomas include: surgery, radiation therapy, and chemotherapy.

Surgical treatment of gliomas

The open surgery, by means of a craniotomy, is primary type of treatment of malignant gliomas. The purpose of surgery is removal of a visible part of a tumor in the maximum volume without damage of normal neurologic functions. The invasive and infiltrative nature of malignant gliomas does this procedure by very difficult task, despite recent advances in operational neurosurgery. Fortunately, new technologies, such as operative microscopes, technology of preparation under a microscope, intraoperativny ultrasound, intraoperativny mapping of a brain, and the newest achievement – MRT scanning in real time that does a surgical resection of gliomas of safer, than earlier. Among patients with anaplastic astrocytomas and glioblastoma, there is a certain increase in survival at those patients whose tumors are placed in a frontal lobe of a brain. Aggressive removal of a malignant glioma can soften the symptoms caused by the size of a tumor at once and to increase efficiency of other therapies; in case of not removals, necrotic central parts of a tumor tend to be rather steady against radiation and chemotherapy. Moreover, the resection of a malignant glioma gives to the neuropathologist the best examples of fabric and allows to carry out the optimum histologic and genetic analysis of a tumor.

Radiotheraphy and chemotherapy.

The radiotheraphy and chemotherapy is widely used as secondary or additional treatment after surgery. Both therapies have effect of control of growth of a tumor. Among patients who are not a candidate for surgical treatment carrying out or radiations or chemotherapy as primary treatment is shown, but generally it occurs only after confirmation of the diagnosis a malignant glioma by means of a biopsy. Patients reckon improper for surgery with the following indicators:

    * Instability from the medical point of view;
    * Existence of several types of cancer at the same time;
    * Existence of spread of a tumor to both hemispheres;
    * A glioma location in inoperable location (for example, a brain trunk);
    * Unwillingness of passing of surgical treatment.

The therapeutic role of postoperative radiotheraphy clearly was established in the random sample which is carried out by group on a question of a brain (Brain Tumor Cooperative Group) 25 years ago. In this research 14 weeks survival for the patients who studied surgery was prolonged up to 42 weeks by means of use of everyday (fractional) radiotheraphy throughout the 6 weeks period. The usual total dose of traditional radiotheraphy used for treatment of malignant gliomas averaged 60 Gray (Гр). Such treatment is directed to a tumor, including 2-3 cm of the structures surrounding a tumor.

The usual modern radiotheraphy uses the linear accelerator for the direction of beams of radiation on a tumor from the different directions. The most modern methods of radiotheraphy use the devices for the direction of beams for the best compliance of volume of the purpose controlled by the computer with a tumor form that there takes place treatment. The best of these the technician called by radiation therapy with the modulated intensity are used by the computer for a variation of intensity and a form of each bunch of radiation. True advantage radiation therapy with the modulated intensity is in the best compliance of an exposure dose with a tumor, even when defeat has very irregular shape.

Complications after radiotheraphy

With traditional fractional radiotheraphy, usual short-term side effects (duration from day to one week) the fatigue, loss of appetite and nausea is. Reddening on skin and loss of hair often can be also shown. Later side effects (happen over months-years after treatment passing) can include the varying extents of loss of memory and deterioration in thinking. Less often patients can experience deterioration in pituitary function or a radiation necrosis (copulation of dead cells and rubtsevy fabric). The radiation necrosis can provoke symptoms that are often similar to primary tumor of a brain, and can include headaches, weakness at the movements, problems with sight, or epileptic seizures.
Gliomas are not curable. The forecast with hard cases to gliomas is not favorable for patients. With cases of maligantny gliomas, only 50% of patients 25% after the second year survive within the first year after establishment of the diagnosis, and.