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Gliomas

Background

Gliomas are the most common type of primary brain tumor.

Stage is not useful in the treatment of gliomas, and is not used.

There are 3 major types of gliomas, based on their cell of origin: astrocytomas, ependymomas and oligodendrogliomas.

Each major type is divided by grade (how bad the cells look under a microscope), into low, intermediate and high.

The intermediate form of astrocytoma is called Anaplastic Astrocytoma (AA). The high grade form of astrocytoma is called Glioblastoma Multiforme (GBM).

The most common glioma is unfortunately the GBM. The good news is that progress in treating Glioblastoma has exploded in the last decade.

Evaluation

Symptoms from a glioma depend on tumor location and size; common symptoms include headache, seizure, confusion, weakness, numbness, imbalance or in-coordination and personality change.

Imaging

MRI of the brain with and without contrast (gadolinium) helps both in diagnosis and in targeting surgery or intensity modulated radiation therapy.

Treatment

Because gliomas invade the brain they typically cannot be removed completely. Initial treatment of gliomas involves gross total resection, if this is possible without undue brain trauma.

This is followed by intensity modulated radiation therapy combined with Temozolomide oral chemotherapy. Topical hypothermia can be used to prevent permanent hair loss.

This in turn is followed by monthly temozolomide alone.

If gliomas recur, treatment with Bevacizumab chemotherapy or with Novocure alternating magnetic fields is used.

Exablate MR-guided focused ultrasound is an upcoming treatment modality as well.

What is amazing about this point in the history of treatment of gliomas is that almost all of these treatments have become standard only in the last ten years: IMRT, temozolomide, bevacizumab, topical hypothermia, Novocure alternating magnetic fields and Exablate MR-guided focused ultrasound.

After hundreds of years of treatment and research into gliomas, the only treatments available a decade ago were surgery and radiation.

At the Tulsa Brain Tumor Clinic, our doctors have played critical roles in launching IMRT, topical hypothermia, Novocure and Exablate MR-guided focused ultrasound as treatments for brain gliomas. We are dedicated to making sure that the entire range of treatments is available to our patients.

More importantly, though, the pace of advances in the treatment of gliomas is only picking up. If you or a loved one has a glioma, the doctors of Tulsa Brain Tumor Clinic will make sure that these treatments become available to you first.