Brain Cancer

Rhone-Poulenc Rorer recently announced the start of a phase III clinical trial of its prolifeprosan with carmustine implant (Gliadel Wafer), in conjunction with surgery and radiation, in patients newly diagnosed with malignant glioma. The purpose of this study is to confirm the results of an earlier, small phase III trial showing that the carmustine wafer offers a significant survival advantage over placebo when used with initial surgery for malignant glioma.

A large number of oncogenes have been identified as aberrant in gliomas, but only the erbB oncogene (gene encoding the epidermal growth factor receptor [EGFR]) is amplified in an appreciable number. The loss or

There is certainly no good place to get a brain tumor, but one of the worst is in the lower portion of the brain along the base of the skull. Skull-base tumors are often intimately entwined with critical arteries and cranial nerves that emerge from the base of the brain, making surgical removal challenging and risky.

Neuroblastoma is the most common extracranial solid tumor of childhood, accounting for 15% of cancer-related deaths. These tumors have a predilection for young children; 60% of cases occur before age 2 years and 97%

Researchers may be close to developing an additional weapon for treating a type of rapidly growing, fatal brain tumor that

The lives of rats with an incurable, rapidly progressing form of brain tumor, similar to glioblastoma in humans, is greatly

The failure of chemotherapy to stop glioblastoma may be linked to a deficiency in DNA repair capability in the cell, according

Perhaps contrary to expectations, the presence of an oligodendroglial component in patients with anaplastic astrocytomas was associated with a significantly longer survival than were pure anaplastic tumors. This finding emerged from a randomized

A review of the English literature was undertaken to (1) determine the efficacy of radiation therapy for the treatment of brain metastases, (2) identify prognostic factors, and (3) ascertain whether there is an effect of treatment technique on outcome. Critical analysis of relevant randomized trials indicated that radiation therapy can effectively palliate the symptoms of brain metastases.

Although generally benign tumors, meningiomas can cause serious neurological injury and, at times, vexatious management difficulties. Currently, the accepted management of these tumors is attempted total surgical excision when technically possible and associated with an acceptable risk. However, even with innovations in instrumentation and refinements in surgical technique, the goal of total resection may not be achievable. For these patients, and for those with recurrent tumors, options for treatment include reoperation, radiation therapy, and chemotherapy. Recent developments in surgical technique and instrumentation, radiosurgery, and brachytherapy have increased the treatment options, while clinical trials with tamoxifen and mifepristone (RU486) are adding information on the effectiveness of these drugs as chemotherapeutic agents. While the search continues for a uniformly successful management plan, physicians must be aware of the available options and try to help the patient decide which treatment is appropriate, based on current medical knowledge. [ONCOLOGY 9(1):83-100]

Surgical resection has been the preferred treatment for meningiomas since the era of the pioneering neurosurgeon, Harvey Cushing. The great majority of these tumors are histologically benign, circumscribed lesions that grow slowly and tend to compress and displace, rather than invade, the surrounding intracranial structures. In contrast to the intrinsic brain tumors of glial origin, most meningiomas have well-defined borders, enabling the surgeon to dissect the tumor capsule from the arachnoid lining of the adjacent brain, blood vessels, and cranial nerves. Consequently, complete removal can be accomplished without needing to sacrifice functional tissue. In these cases, surgery is often curative, and associated with the preservation of, if not improvements in, the neurological condition.

Dr. DeMonte has used an interesting case report to provide an excellent summary of the state of the art in the management of meningiomas of the brain.