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Titolo:
MANAGEMENT OF MALIGNANT GLIOMA - ROLE OF SURGERY IN RELATION TO MULTIMODALITY THERAPY
Autore:
BLACK P;
Indirizzi:
ALLEGHENY UNIV HLTH SCI,DEPT NEUROSURG,MCP,HAHNEMANN SCH MED PHILADELPHIA PA 19102
Titolo Testata:
Journal of neurovirology
fascicolo: 2, volume: 4, anno: 1998,
pagine: 227 - 236
SICI:
1355-0284(1998)4:2<227:MOMG-R>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
HIGH-GRADE GLIOMAS; GLIOBLASTOMA-MULTIFORME; SURGICAL RESECTION; BRAIN-TUMORS; COMPUTED-TOMOGRAPHY; RADIATION-THERAPY; SURVIVAL-TIME; EXTENT; ASTROCYTOMAS; RADIOTHERAPY;
Keywords:
MALIGNANT GLIOMA; BRAIN TUMOR; SURGICAL RESECTION; MULTIMODALITY THERAPY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
50
Recensione:
Indirizzi per estratti:
Citazione:
P. Black, "MANAGEMENT OF MALIGNANT GLIOMA - ROLE OF SURGERY IN RELATION TO MULTIMODALITY THERAPY", Journal of neurovirology, 4(2), 1998, pp. 227-236

Abstract

The goals of surgery for malignant glioma are to establish a histological diagnosis and to achieve mechanical cytoreduction to reduce intracranial pressure (ICP) and possibly alter tumor kinetics. There is controversy concerning the question whether the glioma is a focal or diffuse process; it appears that there may be variability between the two extremes in individual cases. The question of the value of surgery hasalso been controversial. Review of the literature suggests that both early and long-term postoperative outcome after radical surgical resection are better than the results of either partial resection or simplebiopsy, in terms of neurological status and duration of survival. Similarly, reoperation for recurrence of glioma offers reasonable extension of quality survival. Despite the desirability of extensive cytoreductive surgery for malignant gliomas, the presence of viable infiltrative cells beyond the margins of the resection necessitate that surgery be a part of an aggressive multimodality therapeutic approach. Adjunctive measures to control the infiltrative component include newer formsof radiotherapy (such as stereotaxic radiosurgery) and newer deliverytechniques for chemotherapy (agents impregnated in biodegradable polymers implanted in the tumor bed after surgical resection), and possibly immunotherapy and gene therapy as they may become feasible in the future, The strategy for management of malignant glioma thus consists ofa combination of extensive surgical resection to reduce the accessible tumor burden, followed in rapid sequence by measures to control the infiltrative portion of the tumor. It is recommended that these measures be offered 'up front' rather than delaying treatment until there isclinical or radiographic evidence of tumor recurrence.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/12/20 alle ore 20:06:49