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Sheikh SF, Akhuj A, Raghuveer R, Saklecha A. Neurophysiotherapy in Grade II Diffuse Astrocytoma: A Case Report. Cureus 2024; 16:e53082. [PMID: 38414688 PMCID: PMC10897357 DOI: 10.7759/cureus.53082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/27/2024] [Indexed: 02/29/2024] Open
Abstract
Diffuse astrocytoma is a slow, progressive, and invasive tumor that develops from astrocytes and there is no discernible boundary between tumor and brain cells. We present a case of a 48-year-old woman with diffuse astrocytoma who experienced sudden left-sided weakness, multiple convulsive episodes, and vomiting. The patient underwent surgery for a left occipital mini craniotomy with complete tumor removal through a titanium burr hole. Postoperatively, the patient complained of bilateral upper and lower extremities weakness, and decreased muscular tone was found; hence, she was referred to undergo neurophysiotherapy. A four-week rehabilitative protocol was started. Physiotherapy is critical in these patients for ensuring early and rapid recovery and treating the condition's clinical manifestations. The outcome measures employed were the tone grading scale, the Brunnstrom recovery stage, and the Functional Independence Measure (FIM). This case study concludes that physiotherapy rehabilitation for an operated case of grade 2 diffuse astrocytoma led to improved lower limb strength, normal tone, and improved functional independence, which helped the patient achieve better functional activities and a greater quality of life.
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Affiliation(s)
- Simran F Sheikh
- Department of Neuro-Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aditi Akhuj
- Department of Neuro-Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Raghumahanti Raghuveer
- Department of Neuro-Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Akshaya Saklecha
- Department of Neuro-Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Krajewski S, Furtak J, Zawadka-Kunikowska M, Kachelski M, Soboń J, Harat M. Functional State and Rehabilitation of Patients after Primary Brain Tumor Surgery for Malignant and Nonmalignant Tumors: A Prospective Observational Study. Curr Oncol 2023; 30:5182-5194. [PMID: 37232851 DOI: 10.3390/curroncol30050393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/17/2023] [Accepted: 05/20/2023] [Indexed: 05/27/2023] Open
Abstract
The aim of this study was to compare the pre- and postoperative function of patients qualifying for resection of malignant and nonmalignant primary brain tumors to determine the relationship among tumor type, function, and the course of rehabilitation after surgery. This single-center, prospective, observational study recruited 92 patients requiring prolonged postoperative rehabilitation during their inpatient stay, who were divided into a nonmalignant tumor group (n = 66) and a malignant tumor group (n = 26). Functional status and gait efficiency were assessed using a battery of instruments. Motor skills, postoperative complications, and length of hospital stay (LoS) were recorded and compared between groups. The frequency and severity of postoperative complications, the time needed to attain individual motor skills, and the proportion of patients losing independent gait (~30%) were similar between groups. However, paralysis and paresis were more frequent in the malignant tumor group before surgery (p < 0.001). While nonmalignant tumor patients deteriorated more according to all scales after surgery, patients with malignant tumors were still characterized by worse ADL, independence, and performance at discharge. Worse functional outcomes in the malignant tumor group did not affect LoS or rehabilitation. Patients with malignant and nonmalignant tumors have similar rehabilitation needs, and patient expectation-especially those with nonmalignant tumors-should be appropriately managed.
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Affiliation(s)
- Stanisław Krajewski
- Department of Physiotherapy, University of Bydgoszcz, Unii Lubelskiej 4, 85-059 Bydgoszcz, Poland
- Department of Neurosurgery, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, Poland
| | - Jacek Furtak
- Department of Neurosurgery, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, Poland
- Department of Neurooncology and Radiosurgery, Franciszek Łukaszczyk Oncology Center, 85-796 Bydgoszcz, Poland
| | - Monika Zawadka-Kunikowska
- Department of Human Physiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Karłowicza 24, 85-092 Bydgoszcz, Poland
| | - Michał Kachelski
- Department of Neurosurgery, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, Poland
| | - Jakub Soboń
- Department of Neurosurgery, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, Poland
| | - Marek Harat
- Department of Neurosurgery, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, Poland
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Crystalloids vs. colloids for fluid optimization in patients undergoing brain tumour surgery. Radiol Oncol 2022; 56:508-514. [PMID: 36098062 PMCID: PMC9784374 DOI: 10.2478/raon-2022-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 07/05/2022] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND This randomised, double-blinded, single-centre study prospectively investigated the impact of goal directed therapy and fluid optimization with crystalloids or colloids on perioperative complications in patients undergoing brain tumour surgery. Main aim of the study was to investigate the impact of fluid type on postoperative complications. PATIENTS AND METHODS 80 patients were allocated into two equal groups to be optimised with either crystalloids (n = 40) or colloids (n = 40). Invasive hemodynamic monitoring was used to adjust and maintain mean arterial pressure and cerebral oxygenation within the baseline values (± 20%) and stroke volume variation (SVV) ≤ 10%. Postoperative complications from different organ systems were monitored during the first 15 days after surgery. Hospital stay was also recorded. RESULTS Crystalloid group received significantly more fluids (p = 0.003) and phenylephrine (p = 0.02) compared to colloid group. This did not have any significant impact on perioperative complications and hospital stay, since no differences between groups were observed. CONCLUSIONS Either crystalloids or colloids could be used for fluid optimization in brain tumour surgery. If protocolised perioperative haemodynamic management is used, the type of fluid does not have significant impact on the outcome.
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Krajewski S, Furtak J, Zawadka-Kunikowska M, Kachelski M, Birski M, Harat M. Rehabilitation Outcomes for Patients with Motor Deficits after Initial and Repeat Brain Tumor Surgery. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10871. [PMID: 36078585 PMCID: PMC9518489 DOI: 10.3390/ijerph191710871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/22/2022] [Accepted: 08/30/2022] [Indexed: 05/31/2023]
Abstract
Repeat surgery is often required to treat brain tumor recurrences. Here, we compared the functional state and rehabilitation of patients undergoing initial and repeat surgery for brain tumors to establish their individual risks that might impact management. In total, 835 patients underwent operations, and 139 (16.6%) required rehabilitation during the inpatient stay. The Karnofsky performance status, Barthel index, and the modified Rankin scale were used to assess functional status, and the gait index was used to assess gait efficiency. Motor skills, postoperative complications, and length of hospital stay were recorded. Patients were classified into two groups: first surgery (n = 103) and repeat surgery (n = 30). Eighteen percent of patients required reoperations, and these patients required prolonged postoperative rehabilitation as often as those operated on for the first time. Rehabilitation was more often complicated in the repeat surgery group (p = 0.047), and the complications were more severe and persistent. Reoperated patients had significantly worse motor function and independence in activities of daily living before surgery and at discharge, but the deterioration after surgery affected patients in the first surgery group to a greater extent according to all metrics (p < 0.001). The length of hospital stay was similar in both groups. These results will be useful for tailoring postoperative rehabilitation during a hospital stay on the neurosurgical ward as well as planning discharge requirements after leaving the hospital.
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Affiliation(s)
- Stanisław Krajewski
- Department of Physiotherapy, University of Bydgoszcz, Unii Lubelskiej 4, 85-059 Bydgoszcz, Poland
- Department of Neurosurgery, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, Poland
| | - Jacek Furtak
- Department of Neurosurgery, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, Poland
- Department of Neurooncology and Radiosurgery, Franciszek Łukaszczyk Oncology Center, 85-796 Bydgoszcz, Poland
| | - Monika Zawadka-Kunikowska
- Department of Human Physiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Karłowicza 24, 85-092 Bydgoszcz, Poland
| | - Michał Kachelski
- Department of Neurosurgery, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, Poland
| | - Marcin Birski
- Department of Neurosurgery, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, Poland
| | - Marek Harat
- Department of Neurosurgery, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, Poland
- Department of Neurosurgery and Neurology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, M. Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland
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Krajewski S, Furtak J, Zawadka-Kunikowska M, Kachelski M, Birski M, Harat M. Comparison of the Functional State and Motor Skills of Patients after Cerebral Hemisphere, Ventricular System, and Cerebellopontine Angle Tumor Surgery. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2308. [PMID: 35206503 PMCID: PMC8871731 DOI: 10.3390/ijerph19042308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/08/2022] [Accepted: 02/15/2022] [Indexed: 01/27/2023]
Abstract
Brain tumor location is an important factor determining the functional state after brain tumor surgery. We assessed the functional state and course of rehabilitation of patients undergoing surgery for brain tumors and assessed the location-dependent risk of loss of basic motor skills and the time needed for improvement after surgery. There were 835 patients who underwent operations, and 139 (16.6%) required rehabilitation during the inpatient stay. Karnofsky Performance Scale, Barthel Index, and the modified Rankin scale were used to assess functional status, whereas Gait Index was used to assess gait efficiency. Motor skills, overall length of stay (LOS) in hospital, and LOS after surgery were recorded. Patients were classified into four groups: cerebral hemisphere (CH), ventricular system (VS), and cerebellopontine angle (CPA) tumors; and a control group not requiring rehabilitation. VS tumor patients had the lowest scores in all domains compared with the other groups before surgery (p < 0.001). Their performance further deteriorated after surgery and by the day of discharge. They most often required long-lasting postoperative rehabilitation and had the longest LOS (35 days). Operation was most often required for CH tumors (77.7%), and all metrics and LOS parameters were better in these patients (p < 0.001). Patients with CPA tumors had the best outcomes (p < 0.001). Most patients (83.4%) with brain tumors did not require specialized rehabilitation, and LOS after surgery in the control group was on average 5.1 days after surgery. VS tumor patients represent a rehabilitation challenge. Postoperative rehabilitation planning must take the tumor site and preoperative condition into account.
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Affiliation(s)
- Stanisław Krajewski
- Department of Physiotherapy, University of Bydgoszcz, Unii Lubelskiej 4, 85-059 Bydgoszcz, Poland
- Department of Neurosurgery, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, Poland; (J.F.); (M.K.); (M.B.); (M.H.)
| | - Jacek Furtak
- Department of Neurosurgery, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, Poland; (J.F.); (M.K.); (M.B.); (M.H.)
- Franciszek Łukaszczyk Oncology Center, Department of Neurooncology and Radiosurgery, 85-796 Bydgoszcz, Poland
| | - Monika Zawadka-Kunikowska
- Department of Human Physiology, LudwikRydygier Collegium Medicum in Bydgoszcz Nicolaus Copernicus University in Torun, Karłowicza 24, 85-092 Bydgoszcz, Poland;
| | - Michał Kachelski
- Department of Neurosurgery, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, Poland; (J.F.); (M.K.); (M.B.); (M.H.)
| | - Marcin Birski
- Department of Neurosurgery, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, Poland; (J.F.); (M.K.); (M.B.); (M.H.)
| | - Marek Harat
- Department of Neurosurgery, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, Poland; (J.F.); (M.K.); (M.B.); (M.H.)
- Department of Neurosurgery and Neurology, LudwikRydygier Collegium Medicum in Bydgoszcz Nicolaus Copernicus University in Torun, M. Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland
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Weyer-Jamora C, Brie MS, Luks TL, Smith EM, Hervey-Jumper SL, Taylor JW. Postacute Cognitive Rehabilitation for Adult Brain Tumor Patients. Neurosurgery 2021; 89:945-953. [PMID: 33586764 PMCID: PMC8600173 DOI: 10.1093/neuros/nyaa552] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 11/04/2020] [Indexed: 11/14/2022] Open
Abstract
Intrinsic brain tumors often occur within functional neural networks, leading to neurological impairment and disability of varying degrees. Advances in our understanding of tumor-network integration, human cognition and language processing, and multiparametric imaging, combined with refined intraoperative tumor resection techniques, have enhanced surgical management of intrinsic brain tumors within eloquent areas. However, cognitive symptoms impacting health-related quality of life, particularly processing speed, attention, concentration, working memory, and executive function, often persist after the postoperative recovery period and treatment. Multidisciplinary cognitive rehabilitation is the standard of care for addressing cognitive impairments in many neurological diseases. There is promising research to support the use of cognitive rehabilitation in adult brain tumor patients. In this review, we summarize the history and usefulness of postacute cognitive rehabilitation for adult brain tumor patients.
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Affiliation(s)
- Christina Weyer-Jamora
- Department of Neurological Surgery, University of CaliforniaSan Francisco, San Francisco, California
- Department of Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco, California
| | - Melissa S Brie
- Department of Neurological Surgery, University of CaliforniaSan Francisco, San Francisco, California
- Department of Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco, California
| | - Tracy L Luks
- Department of Radiology and Biomedical Imaging, University of CaliforniaSan Francisco, San Francisco, California
| | - Ellen M Smith
- Department of Neurological Surgery, University of CaliforniaSan Francisco, San Francisco, California
| | - Shawn L Hervey-Jumper
- Department of Neurological Surgery, University of CaliforniaSan Francisco, San Francisco, California
| | - Jennie W Taylor
- Department of Neurological Surgery, University of CaliforniaSan Francisco, San Francisco, California
- Department of Neurology, University of California San Francisco, San Francisco, California, USA
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Krajewski S, Wójcik M, Harat M, Furtak J. Influence of Epilepsy on the Quality of Life of Patients with Brain Tumors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126390. [PMID: 34204841 PMCID: PMC8296208 DOI: 10.3390/ijerph18126390] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 11/16/2022]
Abstract
Epilepsy is a common consequence of brain tumors, occurring in 35 to 75% of cases. Here we evaluated the influence of epilepsy on the quality of life (QoL) of patients with malignant brain tumors (primary and metastatic) and assessed which areas of function are most affected by epilepsy and brain tumors. Sixty patients undergoing brain tumor surgery at the Neurosurgery Clinic of the 10th Military Research Hospital, Bydgoszcz, Poland (30 with epilepsy and 30 without epilepsy) were studied. Relationships between categorical variables were determined with Pearson’s chi-squared test, while continuous data were analyzed with the Mann-Whitney U-test. A p value < 0.05 was considered statistically significant. A multiple regression model was used for multivariate analysis of QoL. Patients with epilepsy more frequently reported memory disorders as a problem in their daily life. There were trends towards greater impairments in social, professional, and family life, sports and recreational activities, and daily physical activities in brain tumor patients with epilepsy rather than those without epilepsy. Higher frequency and generalized seizures significantly and adversely influenced the ability of patients to leave home and drive vehicles, but a proportion of patients with frequent, generalized seizures continued to drive regardless. Patients with generalized seizures considered the adverse effects of taking medicines as significantly disruptive. Memory disorders significantly affect the QoL of patients with epilepsy, and the importance of stopping driving must be emphasized by all healthcare professionals.
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Affiliation(s)
- Stanisław Krajewski
- Department of Physiotherapy, University of Bydgoszcz, 85-059 Bydgoszcz, Poland;
- Department of Neurosurgery, 10th Military Research Hospital, 85-681 Bydgoszcz, Poland; (M.H.); (J.F.)
- Correspondence:
| | - Magdalena Wójcik
- Department of Physiotherapy, University of Bydgoszcz, 85-059 Bydgoszcz, Poland;
| | - Marek Harat
- Department of Neurosurgery, 10th Military Research Hospital, 85-681 Bydgoszcz, Poland; (M.H.); (J.F.)
- Department of Neurosurgery and Neurology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 87-100 Toruń, Poland
| | - Jacek Furtak
- Department of Neurosurgery, 10th Military Research Hospital, 85-681 Bydgoszcz, Poland; (M.H.); (J.F.)
- Department of Neurooncology and Radiosurgery, Franciszek Łukaszczyk Oncology Center, 85-796 Bydgoszcz, Poland
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Correia MS, Neville IS, Almeida CCD, Hayashi CY, Ferreira LTD, Quadros DG, Gomes Dos Santos A, Solla DJF, Marta GN, Teixeira MJ, Paiva WS. Clinical outcome assessments of motor status in patients undergoing brain tumor surgery. Clin Neurol Neurosurg 2020; 201:106420. [PMID: 33388662 DOI: 10.1016/j.clineuro.2020.106420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/21/2020] [Accepted: 12/04/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Clinical outcome assessment (COA) is an important instrument for testing the effectiveness of treatments and for supporting healthcare professionals on decision-making. This review aims to assess the use of COAs, and the evaluation time points of motor status in patients with brain tumor (BT) undergoing surgery. METHODS We performed a scoping review through MEDLINE, EMBASE, and LILACS databases, looking for original studies in primary or secondary BT, having motor function status as the primary outcome. EXCLUSION CRITERIA mixed sample, BT recurrence, and an unspecific description of motor deficits evaluation. RESULTS Nine studies met the eligibility criteria. There were 449 patients assessed. A total of 18 scales evaluated these BT patients, 12 performance outcomes measures (PerfO) tested motor function. Four scales were the clinician-reported outcome measures (ClinRO) found in this review, two assessed performance status, and two rated ambulation. Two patient-reported outcome measures (PRO) appraised functionality. CONCLUSIONS A variety of instruments were used to assess BT patients. Rehabilitation studies are more likely to associate the use of PerfO and PRO concerning motor and functional status. The use of specific validated scales to the BT population was rare. The lack of a standardized approach hampers the quality of BT patient's assessment.
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Affiliation(s)
- Mayla Santana Correia
- Instituto do Cancer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, 01246-000, Brazil.
| | - Iuri Santana Neville
- Instituto do Cancer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, 01246-000, Brazil; Division of Neurosurgery, LIM-62, Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, 01246-903, Brazil
| | - Cesar Cimonari de Almeida
- Division of Neurosurgery, LIM-62, Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, 01246-903, Brazil
| | - Cintya Yukie Hayashi
- Division of Neurosurgery, LIM-62, Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, 01246-903, Brazil
| | - Luana Talita Diniz Ferreira
- Hospital Samaritano Paulista, Sao Paulo, 01333-030, Brazil; School of Public Health, University of Sao Paulo, Sao Paulo, 01246-904, Brazil
| | - Danilo Gomes Quadros
- Division of Neurosurgery, LIM-62, Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, 01246-903, Brazil
| | | | - Davi Jorge Fontoura Solla
- Division of Neurosurgery, LIM-62, Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, 01246-903, Brazil
| | - Gustavo Nader Marta
- Instituto do Cancer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, 01246-000, Brazil; Department of Radiation Oncology, Hospital Sírio-Libanês, Sao Paulo, 01308-050, Brazil
| | - Manoel Jacobsen Teixeira
- Division of Neurosurgery, LIM-62, Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, 01246-903, Brazil; Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, 01246-903, Brazil
| | - Wellingson Silva Paiva
- Division of Neurosurgery, LIM-62, Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, 01246-903, Brazil; Hospital Samaritano Paulista, Sao Paulo, 01333-030, Brazil
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Mesti T, Ocvirk J. Malignant gliomas: old and new systemic treatment approaches. Radiol Oncol 2016; 50:129-38. [PMID: 27247544 PMCID: PMC4852970 DOI: 10.1515/raon-2015-0003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 09/29/2014] [Indexed: 12/15/2022] Open
Abstract
Background Malignant (high-grade) gliomas are rapidly progressive brain tumours with very high morbidity and mortality. Until recently, treatment options for patients with malignant gliomas were limited and mainly the same for all subtypes of malignant gliomas. The treatment included surgery and radiotherapy. Chemotherapy used as an adjuvant treatment or at recurrence had a marginal role. Conclusions Nowadays, the treatment of malignant gliomas requires a multidisciplinary approach. The treatment includes surgery, radiotherapy and chemotherapy. The chosen approach is more complex and individually adjusted. By that, the effect on the survival and quality of life is notable higher.
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Affiliation(s)
- Tanja Mesti
- Department of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
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