MANAGEMENT OPTIONS FOR CEREBRAL GLIOMAS

Abstract

Background: Cerebral gliomas are the most prevalent primary brain tumors in adult patients. Objectives: The purpose of this prospective study was evaluation of various management strategies including surgery facilitated by intraoperative ultrasonography, radiotherapy and chemotherapy with addressing impact of various factors on the outcome. Patients and methods: In a prospective evaluation, we studied 55 adult patients with primary cerebral gliomas who were operated upon at our department between January 2009 and January 2011 with follow up at least one year for survived patients. Radiotherapy was received postoperatively by 48 patients of whom 34 patients received chemotherapies. All clinical, radiological, imaging, pathological and management modality records were evaluated as prognostic factors. Results: The mean survival time was 13.7 months. We confirmed that the patient age, preoperative functional status (by Karnofesky scale), location of cerebral gliomas, size of gliomas, extent of resection, intraoperative ultrasonography use, grades of glioma and postoperative functional status as decisive prognostic factors and had an impact on outcome. Conclusion: We could show that young ages (≥ 16-40 years), high preoperative Karnofesky scores (≥ 80%), single-lobe involvement by glioma, small tumor size (≤ 5 cm), gross total resection, intraoperative ultrasonography use, low-grade gliomas and high postoperative Karnofesky scores (≥ 80%) were predictors for better outcome.
Keywords: cerebral glioma, survival, prognosis, outcome, intraoperative ultrasound