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Glial Neoplasms
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Gliomas, or tumors that arise from the cells that support the actual nerve cells in the brain and spinal cord, are the most common primary brain tumors diagnosed in adults and children. This general category of neoplasms includes both benign (non-cancerous) and malignant (cancerous) forms of astrocytomas, ependymomas, oligodendrogliomas, and microglial tumors. These tumors should be differentiated from brain metastases, which arise elsewhere in the body and are described on another page of this web site. This category includes the most commonly diagnosed cancerous primary brain tumors, anaplastic astrocytoma and glioblastoma multiforme, which are malignant forms of astrocytomas. These very threatening tumors are conventionally treated with surgery and external beam radiotherapy. More recently, chemotherapy is being used for these aggressive tumors as well. The role of Gamma Knife radiosurgery in the management of malignant gliomas continues to evolve. Currently, selected patients with malignant gliomas may benefit from a boost of additional radiation to the residual tumor or cavity after surgery and external beam radiation. The use of the Gamma Knife will be limited by the size of the lesion, the general health of the patient, and the location of the tumor within the brain. Gamma Knife radiosurgery may also play a role as treatment for recurrences of malignant glioma after more standard therapy. The same limitations as noted above will also apply. Lower grade or benign gliomas exhibit very different growth characteristics compare to their malignant counterparts. The most common type of low grade glioma is called a fibrillary astrocytoma and appears as a diffuse infiltrative lesion on brain scans. These tumors have variable growth rates, but often grow very slowly over years. Some of the more uncommon low grade gliomas, including pilocytic astrocytomas (usually seen in pediatric patients), pleomorphic xanthroastrocytomas, and giant cell astrocytomas, have more of a distinct, pushing border. There is published experience demonstrating effectiveness in controlling these more unusual tumors with Gamma Knife radiosurgery. The use of the Gamma Knife as opposed to other modalities including surgery, external beam radiotherapy, and/or chemotherapy should be evaluated by a multidisciplinary team on a case by case basis. [Keywords: gliomas, tumors; glial neoplasm, brain, spinal cord, anaplastic astrocytoma, glioblastoma multiforme, malignant, astrocytomas] |
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