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Primary Brain Tumors: Characteristics, Practical Diagnostic and Treatment Approaches

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Glioblastoma

Abstract

Primary brain tumors are classified according to the tissue of phylogenic origin. Tumors arising from the neuroepithelium encompass a subgroup of neoplasms collectively referred to as “Gliomas”. Of this subgroup; astrocytomas are by far the most common. Astrocytomas are further subdivided by a four tier grading system based on The World Health Organization (WHO) classification where Grade I tumors represent the most benign and am enable to cure by surgical resection. Grade II astrocytomas are more infiltrative, but less aggressive than their more malignant counterpart Grades III and IV. However, due to their infiltrative nature grades II-IV are not cured by surgical extirpation. The most frequently used treatment regimen for malignant primary brain tumors include surgery for debulking or biopsy followed by postoperative radiation that is often combined with chemotherapy followed by 6 months of adjuvant chemotherapy. When paired with improved imaging and diagnostic modalities as well as new anti-angiogenic and molecular targeted therapies, the outcome for patients newly diagnosed with a malignant glioma has improved considerably. In addition, cancer stem cell research offers insight into the biology and pathogenesis of primary brain tumors. Currently, many studies implementing angiogenesis inhibitors and biologic modifiers offer encouragement for more patient participation in well-designed clinical trials for those patients who are eligible.

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References

  • Arai K, Sato N, Aoki J et al (2006) MR signal of the solid portion of pilocytic astrocytoma on T2 weighted imaging: is it useful for differentiation from medulloblastoma? Neuroradiology 48(4):233–237

    Article  PubMed  Google Scholar 

  • Batchelor TT, Carson K, O’Neill A, Grossman SA, Priet R (2003) Treatment of primary CNS lymphoma with methotrexate and deferred radiotherapy: a report of NABTT 96-97. J Clin Oncol 21(6):1044–1049

    Article  CAS  PubMed  Google Scholar 

  • Batchelor TT, Loeffler JS (2006) Primary CNS lymphoma. J Clin Oncol 24(8):1281–1288

    Article  CAS  PubMed  Google Scholar 

  • Batchelor TT, Gilbert MR, Supko JG, Phuphanich S et al (2004) Phase 2 study of weekly Irinotecan in adults with recurrent malignant glioma: final report of NABTT 97-11. Neuro Oncol 6(1):21–27

    Article  CAS  PubMed  Google Scholar 

  • Batchelor TT, Lesser GL, Grossman SA (2008) Rituximab monotherapy for relapsed or progressed primary central system lymphoma. J Clin Oncol 26(15S):99s abstr 2043

    Google Scholar 

  • Bauman GS, Ino Y, Ueki K, Zlatescu MC, Fisher BJ, MacDonald DR, Stitt L, Louis DN, Cairncross JG (2000) Allelic loss of chromosome 1p and radiotherapy plus chemotherapy in patients with oligodendrogliomas. Int J Radiat Oncol Biol Phys 48(2):825–830

    CAS  PubMed  Google Scholar 

  • Berger MS, DeAngelis AV, Dobbins J, Keles GE (1994) The effect of extent of resection on recurrence in patients with low grade cerebral hemisphere gliomas. Cancer 74(6):1784–1791

    Article  CAS  PubMed  Google Scholar 

  • Brada M, Viviers L, Abson C, Hines F, Britton J, Ashley S, Sardell S, Traish D, Gonsalves A, Wilkins P, Westbury C (2003) Phase II study of primary Temozolomide chemotherapy in patients with WHO grade II gliomas. Ann Oncol 14:1715–1721

    Article  CAS  PubMed  Google Scholar 

  • Brandes AA, Franceschi E, Tosoni A, Hegi ME, Stupp R (2008) Epidermal growth factor receptor inhibitors in neuro-oncology: hopes and disappointments. Cin Cancer Res 14(4):957–960

    CAS  Google Scholar 

  • Brown MT, Friedman HS, Oakes WJ, Boyko OB, Hockenberger B, Schold SC Jr (1993) Chemotherapy for pilocytic astrocytomas. Cancer 71(10):3165–3172

    Article  CAS  PubMed  Google Scholar 

  • Burrows RC, Wancio D, Levitt P, Lillien L (1997) Response diversity and the timing of progenitor cell maturation are eegulated by developmental changes in EGFr expression in the cortex. Neuron 19:251–267

    Article  CAS  PubMed  Google Scholar 

  • Cabone M, Bocchetta M, Cristaudo A, Gazdar A, Jasani B (2003) SV40 and human brain tumors. Int J cancer 106(1):140–142

    Article  Google Scholar 

  • Cahill DP, Levine KK, Betensky RA, Codd PJ, Romany CA, Louis DN et al (2007) Loss of mismatch repair protein MSH6 in human glioblastomas is associated with tumor progression during temozolomide treatment. Clin Cancer Res 13(7):2038–2045

    Article  CAS  PubMed  Google Scholar 

  • Cairncross JG, Macdonald DR (1988) Successful chemotherapy for recurrent malignant oligodendroglioma. Ann Neurol 23(4):360–364

    Article  CAS  PubMed  Google Scholar 

  • Cairncross G, Berkey B, Shaw E, Jenkins R, Scheithauer B, Brachman D, Buckner J, Fink K, Souhami L, Laperierre N, Mehta M, Curran W (2006) Phase III trial of chemotherapy plus radiotherapy compared with radiotherapy alone for pure and mixed anaplastic oligodendroglioma: intergroup radiation therapy oncology group trial 9402. J Clin Oncol 24(18):2707–2714

    Article  CAS  PubMed  Google Scholar 

  • Cairncross JG, Ueki K, Zlatescu MC et al (1998) Specific genetic predictors of chemotherapeutic response and survival in patients with anaplastic oligodendrogliomas. J Natl Cancer Inst 90:1473–1479

    Article  CAS  PubMed  Google Scholar 

  • Celli P, Nofrone I, Palma L, Cantore G, Fortuna A (1994) Cerebral oligodendroglioma: prognostic factors and life history. Neurosurgery 35(6):1018–1034

    Article  CAS  PubMed  Google Scholar 

  • Central Brain Tumor Registry of The United States (CBTRUS) 2005–2006.

    Google Scholar 

  • Chamberlain MC (2003) Ependymomas. Curr Neurol Neurosci Rep 3(3):193–199

    Article  PubMed  Google Scholar 

  • Chamberlain MC, Glantz MJ, Fadul CE (2007) Recurrent meningioma: salvage therapy with long acting somatostatin analogue. Neurology 69(10):969–973

    Article  CAS  PubMed  Google Scholar 

  • Chinot OL, Honore S, Dufour H, Barrie M, Figarella-Bronger D, Muracciole X, Braguer D, Marie-martin P, Grisoli F (2001) Safety and efficacy of Temozolomide in patients with recurrent anaplastic oligodendrogliomas after standard radiotherapy and chemotherapy. J Clin Oncol 19(9):2449–2455

    CAS  PubMed  Google Scholar 

  • Cloughesy TF, Prados MD, Mikkelsen T, Abrey LE, Schiff D, Friedman HS et al (2008) A phase II, randomized, non-comparative clinical trial of the effect of Bevacizumab (BV) alone or in combination with irinotecan (CPT-11) on 6 month progression free survival (PFS6) in recurrent, treatment-refractory glioblastoma (GBM). J Clin Oncol 26:91s, abstr 2010b

    Google Scholar 

  • Coons SW, Johnson PC, Scheithaur BW, Yates AJ, Pearl DK (1997) Improving diagnostic accuracy and interobserver concordance in the classification and grading of primary gliomas. Cancer 79(7):1381–1393

    Article  CAS  PubMed  Google Scholar 

  • Couldwell WT, Hinton DR, Sunok AA, DeGiorigo CM, Weiss MH et al (1996) Treatment of recurrent malignant gliomas with chronic high oral high dose tamoxifen. Clin Cancer Res 2:619–622

    CAS  PubMed  Google Scholar 

  • DeAngelis LM, Yahalom J, Thaler HT, Kher U (1992) Combined modality therapy for primary CNS lymphoma. J Clin Oncol 10(4):635–643

    CAS  PubMed  Google Scholar 

  • Deutsch M, Green SB, Strike TA, Paoletti P et al (1989) Results of a randomized trial comparing BCNU plus radiotherapy, streptozocin plus radiotherapy, BCNU plus hyperfractionated radiotherapy and BCNU following misonidazole plus radiotherapy in postoperative treatment of malignant glioma. Int J Radiat Oncol Biol Phys 16(6):1389–1396

    Article  CAS  PubMed  Google Scholar 

  • Fewer D, Wilson CB, Boldrey EB, Enot KJ, Powell MR (1972) The chemotherapy of brain tumors. Clinical experience with carmustine (BCNU) and vincristine. JAMA 222(5):549–552

    Article  CAS  PubMed  Google Scholar 

  • Fine HA, Figg WD, Jaeckle K, Wen PY, Athanassios PK, Loeffler JS, Levin VA, Black PM, Kaplan R, Pluda JM, Yung WK (2000) Phase II trial of the anti-angiogenic agent thalidomide in patients with recurrent high grade gliomas. J Clin Oncol 18(4):708–715

    CAS  PubMed  Google Scholar 

  • Fisher R, Fadul C, Chamberlain MC et al (2006) Potential efficacy of somatostatin for treatment of recurrent meningiomas. Neurology 66(2 Suppl)):A339 Abstr. P06 019

    Google Scholar 

  • Furie DM, Provenzale JM (1985) Supratentorial ependymomas and subependymomas: CT and MR appearance. J Comput Assist Tomogr 19(4):518–526

    Article  Google Scholar 

  • Ginsberg LE, Fuller GE, Hashmi M, Leeds NE, Schomer DF (1998) The significance of lack of MR contrast enhancement of supratentorial brain tumors in adults: histopathological evaluation of a series. Surg Neurol 49(4):436–440

    Article  CAS  PubMed  Google Scholar 

  • Glantz MJ, Cole BF, Recht L, Akerley W, Egorin MJ et al (1988) High dose intravenous methotrexate for patients with nonleukemic leptomeningeal cancer: is intrathecal chemotherapy necessary?. J Clin Oncol 16(4):1561–1567

    Google Scholar 

  • Glass J, Gruber ML, Cher L, Hochberg FH (1994) Preirradiation methotrexate chemotherapy of primary central nervous system lymphoma: long-term outcome. J Neurosurg 81(2):188–195

    Article  CAS  PubMed  Google Scholar 

  • Grant JW, Isaacson PG (1997) Primary central nervous system lymphoma. Brain Pathol 2(2):97–109

    Article  Google Scholar 

  • Haas-Kogen DA, Prados MD, Tihan T, Eberhard DA, Jelluma N, Arnold ND, Baumber R, Lamborn KR, Kapadia A, Malec M, Berger MS, Stokoe D (2005) Epidermal growth factor receptor, protein kinase B/Akt, and glioma response to erlotinib. J Natl Cancer Inst 97(12):880–887

    Article  Google Scholar 

  • Hoang-Xuan K, Capelle L, Kujas M et al (2004) Temozolomide as initial treatment for adults with low grade oligodendrogliomas or oligoastrocytomas and correlation with chromosome 1 p deletions. J Clin Oncol 22(15):3133–3138

    Article  CAS  PubMed  Google Scholar 

  • Hormigo A, DeAngelis LM (2003) Primary ocular lymphoma: clinical features, diagnosis, and treatment. Clin Lymphoma 4(1):22–29

    Article  PubMed  Google Scholar 

  • Jaaskelainen J, Haltia M, Servo A (1986) Atypical and anaplastic meningioma: radiology, surgery, radiotherapy, and outcome. Surg Neurol 25(3):233–242

    Article  CAS  PubMed  Google Scholar 

  • Jackson RJ, Fuller GN, Abi-aid D, Lang FF, Sawya R (2001) Limitations of stereotactic biopsy in the initial management of gliomas. Neuro Oncol 3(3):193–200

    CAS  PubMed  Google Scholar 

  • Jenkins RB, Blair H, Ballman KV, Giannini C, Arusell RM, Law M, Flynn H, Passe S, Felten S, Brown PD, Shaw EG, Buckner JC (2006) A t(1:19)(q10;p10) Mediates the combined deletions of 1p and 19q and predicts a better prognosis of patients with oligodendroglioma. Cancer Res 66(20):9852–9861

    Article  CAS  PubMed  Google Scholar 

  • Johannes S, Martin S, Michael B, Ernst HG, Richard M et al. (2000) A role of preirradiation PCV chemotherapy for oligodendroglial brain tumors. J Neurol 247(4):297–302

    Article  Google Scholar 

  • Kaba SE, DeMonte F, Bruner JM, Yung WK (1997) The treatment of recurrent unresectable and malignant meningioma with interferon alpha-2B. Neurosurgery 40(2):271–275

    Article  CAS  PubMed  Google Scholar 

  • Karamitopoulou E, Perentes E, Diamantis I, Maraziotis T (1994) Ki-67 immunoreactivity in human central nervous system tumors: a study with MIB 1 monoclonal antibody on archival material. Acta Neuropathol 87(1):47–54

    Article  CAS  PubMed  Google Scholar 

  • Karim AB, Afra D, Cornu P, Bleehan N, van Glabbeke M et al (2002) Randomized trial on the efficacy of radiotherapy for cerebral low grade glioma in the adult: European Organization for Research and Treatment of Cancer Study 22845 with the Medical Research Council Study BRO4: an interim analysis. Int J Radiat Oncol Biol Phys 52(2):316–324

    Article  PubMed  Google Scholar 

  • Kim L, Hochberg FH, Thorton AF, Harsh GR, Patel H, Finkelstein D, Louis DN (1996) Procarbazine, lomustine, and vincristine (PCV) chemotherapy for grade III and grade IV oligoastrocytomas. J Neurosurg 85(4):602–607

    Article  CAS  PubMed  Google Scholar 

  • Kros JM, Pieterman H, van Eden CG, Avezaat CJ (1994) Oligodendroglioma: the Rotterdam-Dijkzigt experience. Neurosurgery 34(6):959–966

    Article  CAS  PubMed  Google Scholar 

  • Krouwer HG, Davis RL, Silver P, Prados M (1991) Gemistocytic astrocytomas: a reappraisal. J Neurosurg 74(3):399–406

    Article  CAS  PubMed  Google Scholar 

  • Lacroix M, Abi-Said D, Fourney DR, Sawaya R (2001) A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival. J Neurosurg 95(2):190–198

    Article  CAS  PubMed  Google Scholar 

  • Lassman AB, Rossi MR, Razier JR, Abrey LE et al. (2005) Molecular study of malignant gliomas treated with epidermal growth factor receptor inhibitors: tissue analysis from North American Brain Tumor Consortium Trials 01–03 and 00–01. Clin Cancer Res 11(21):7841–7850

    Article  CAS  PubMed  Google Scholar 

  • Laws ER Jr, Taylor WF, Clifton MB, Okazaki H (1984) Neurosurgical management of low grade astrocytoma of the cerebral hemispheres. J Neurosurg 61(4):665–673

    Article  PubMed  Google Scholar 

  • Lebrun C, Fontaine D, Bourg V, Ramaioli A, Chanalet S, Vandenbos F, Lonjon M, Fauchon F, Paquis P, Frenay M. (2007) Treatment of newly diagnosed symptomatic pure low grade oligodendrogliomas with PCV chemotherapy. Eur J Neurol 14(4):391–398

    Article  CAS  PubMed  Google Scholar 

  • Lee YY, Van Tassel P, Brunner JM, Moser RP, Share JC (1989) Juvenile pilocytic astrocytomas: CT and MR characteristics. AJNR Am J Neuroradiol 10:363–370

    Google Scholar 

  • Leighton C, Fisher B, Bauman G, Depiero S, Stitt L, Macdonald D, Cairncross G (1997) Supratentorial low grade glioma in adults: an analysis of prognostic factors and timing of radiation. J Clin Oncol 15(4):1294–1301

    CAS  PubMed  Google Scholar 

  • Louis DN (1997) A molecular genetic model of astrocytoma histopathology. Brain Pathol 7(2):755–764

    Article  CAS  PubMed  Google Scholar 

  • Louis DN, Ohgaki H, Wiestler OD, Cavenee WK (eds) (2007) WHO classification of tumours of the central nervous system. IARC, Lyon, France

    Google Scholar 

  • Mason WP, Gentilli F, Macdonald DR, Abrey LE et al (2002) Stabilization of disease progression by hydroxyurea in patients with recurrent or unresectable meningioma. J Neurosurg 97(2):341–346

    Article  CAS  PubMed  Google Scholar 

  • Mellinghoff IK, Wang MY, Vivanco I, Mischel PS (2005) Molecular determinants of the response of glioblastomas to EGFr kinase inhibitors. N Engl J Med 353(19):2014–2024

    Article  Google Scholar 

  • Miller DC, Hochberg FH, Harris NL, Gruber ML, Louis DN, Cohen H (1994) Pathology with clinical correlations of primary central nervous system non-Hodgkins lymphoma. The Massachusetts General Hospital experience 1958-1989. Cancer 74:1383–1397

    Article  CAS  PubMed  Google Scholar 

  • Mirimanoff R, Mason W, Van den Bent M, Kortmann R, Taphoom M, Brandes A, Villa S, Vairncross G, Gorlia T, Stupp R (2007) Is long term survival in glioblastoma possible? Updated results of the EORTC/NCIC phase III randomized trial on Radiotherapy (RT) and concomitant and adjuvant temozolomide (TMZ) versus RT alone. Int J Radiat Oncol Biol Phys 69(3 Suppl):S2 abstr 2073A

    Google Scholar 

  • Mohile NA, Deangelis LM, Abrey LE (2008) The utility of body FDG-PET in staging primary central nervous system lymphoma. Neuro Oncol 10(2):223–228

    Article  PubMed  Google Scholar 

  • Montine TJ, Vandersteenhoven JJ, Aguzzi A, Boyko OB, Burger PC (1994) Prognostic significance of Ki-67 proliferation index in supratentorial fibrillary astrocytic neoplasms. Neurosurgery 34(4):674–678

    Article  CAS  PubMed  Google Scholar 

  • Mork SJ, Lindegaard KF, Halvorsen TB, Lehmann EH, Ganz J (1985) Oligodendroglioma: incidence and biological behavior in a defined population. J Neurosurg 63(6):881–889

    Article  CAS  PubMed  Google Scholar 

  • Moynihan TJ (2003) Ependymal tumors. Curr Treat Options Oncol 4(6):517–523

    Article  PubMed  Google Scholar 

  • Muhr C, Gudjonsson O, Lilja A, Langstrom B (2001) Meningioma treated with interferon-alpha, evaluated with [(11)C]-L-methionine positron emission tomography. Clin Cancer Res 7(8):2269–2276

    CAS  PubMed  Google Scholar 

  • Nelson DF (1999) Radiotherapy in the treatment of primary central nervous system lymphoma (PCNSL). J Neurooncol 43(3):241–247

    Article  CAS  PubMed  Google Scholar 

  • Nelson DF, Martz KL, Bonner H, Nelson JS, Murray KJ (1992) Non-hodgkin’s lymphoma of the brain: can high dose, large volume radiation therapy improve survival? Report on a prospective trial by the Radiation Therapy Oncology Group (RTOG): RTOG 8315. Int J Radiat Oncol Biol Phys 23(1):9–17

    Article  CAS  PubMed  Google Scholar 

  • Newton HB (2007) Hydroxyurea chemotherapy in the treatment of meningiomas. Neurosurg Focus 23(4):E11

    Article  PubMed  Google Scholar 

  • Paleologos NA, Macdonald DR, Vick NA, Cairncross JG (1999) Neoadjuvant procarbazine, CCNU, and vincristine for anaplastic and aggressive oligodendroglioma. Neurology 53(5):1141–1143

    CAS  PubMed  Google Scholar 

  • Palma L, Celli P, Franco C, Cervoni L, Cantore G (1997) Long term prognosis for atypical and malignant meningiomas: a study of 71 surgical cases. J Neurosurg 86(5):793–800

    Article  CAS  PubMed  Google Scholar 

  • Parney IF, Chang SM (2003) Current chemotherapy for glioblastoma. Cancer J 9:149–156

    Article  CAS  PubMed  Google Scholar 

  • Pels H, Schulz H, Schlegel U, Engert A (2003) Treatment of CNS lymphoma with anti-CD20 antibody Rituximab: Experience with two cases and review of the literature. Onkologie 26:351–354

    Article  CAS  PubMed  Google Scholar 

  • Pignatti F, van den Bent M, Curran D, Debruyne C, Abul BMF et al (2002) prognostic factors for survival in adult patients with cerebral low-grade gliomas. J Clin Oncol 20(8):2076–2084

    Article  PubMed  Google Scholar 

  • Prados MD, Lamborn K, Yung WKA, Jaeckle K, Kuhn J (2006) A phase II trial of Irinotecan (CPT-11) in patients with recurrent malignant glioma: a North American Brain Tumor Consortium study. Neuro Oncol 8:189–193

    Article  CAS  PubMed  Google Scholar 

  • Ron E, Modan B, Boice JD, Katz L (1988) Tumors of the brain and nervous system after radiotherapy in childhood. N Engl J Med 319(16):1033–1039

    Article  CAS  PubMed  Google Scholar 

  • Rosenthal MA et al (1995) Cerebral lymphoma. In: Kaye AH, Laws ER Jr (eds) Brain tumors. Churchill-Livingstone, Edinburgh, pp 861–869

    Google Scholar 

  • Schabet M (1999) Epidemiology of primary CNS lymphoma. J Neurooncol 43(3):199–201

    Article  CAS  PubMed  Google Scholar 

  • Shaw EG, Wisoff JH (2003) Prospective clinical trials of intracranial low-grade glioma in adults and children. Neuro Oncol 5:153–160

    Article  PubMed  Google Scholar 

  • Shaw EG, Berkey B, Coons SW, Brachman D, Buckner JC, Stelzer KJ, Barger GR, Brown PD, Gilbert MR, Mehta M (2006) Initial report of Radiation Therapy Oncology Group (RTOG) 9802: Prospective studies in adult low-grade glioma. J Clin Oncol 24:18s, abstr 1500

    Google Scholar 

  • Shaw EG, Berkey B, Coons SW, Brachman D, Buckner JC, Stelzer KJ, Barger GR, Brown PD, Gilbert MR, Mehta M (2008) Final report of Radiation Therapy Oncology Group (RTOG) protocol 9802: Radiation therapy (RT) versus RT + procarbazine, CCNU, and vincristine (PCV) chemotherapy for adult low-grade glioma (LGG). J Clin Oncol 26:90s, abstr 2006

    Google Scholar 

  • Smith JS, Perry A, Borell TJ, Hyun K, O’Fallon J, Jenkins RB (2000) Alterations of chromosome arms 1p and 19q as predictors of survival in oligodendrogliomas, astrocytomas, and mixed oligoastrocytomas. J Clin Oncol 18(3):636–645

    CAS  PubMed  Google Scholar 

  • Smith JS, Alderete B, Minn Y, Borell TJ, Jenkins RB et al (1999) Localization of common deletion regions on 1p and 19q in human gliomas and their association with histological subtype. Oncogene 18(28):4144–4152

    Article  CAS  PubMed  Google Scholar 

  • Smith MT, Ludwig CL, Godfrey AD, Armbrustmacher VW (1983) Grading oligodendrogliomas. Cancer 52(11):2107–2114

    Article  CAS  PubMed  Google Scholar 

  • Soffietti R, Costanza A, Nobile M (2002) Temozolomide for recurrent ependymomas of the adult. 2002 ASCO Annual proceedings Abstract No: 2078.

    Google Scholar 

  • Soffietti R, Chio A, Giordana MT, Vasario E, Schiffer D (1989) Prognostic factors in well differentiated cerebral astrocytoma in the adult. Neurosugery 24(5):686–692

    Article  CAS  Google Scholar 

  • Stupp R, Dietrich PY, Kraljevic SO, Pica A, Leyvraz S et al (2002) Promising survival for patients with newly diagnosed glioblastoma multiforme treated with concomitant radiation plus temozolomide followed by adjuvant temozolomide. J Clin Oncol 20(5):1375–1382

    Article  CAS  PubMed  Google Scholar 

  • Taliansky A, Bokstein F, Lavon I et al (2004) Temozolomide (TMZ) as initial treatment for newly diagnosed anaplastic oligodendroglioma: preliminary results. Neuro Oncol 6(4):383 (abstr TA-54)

    Google Scholar 

  • Teri NK, Lyndon K, Kraig M, Paul D, Cheryl R, Irene S, Nancy G, Megan M, John AB, Kevin C, John P, Paul SA, and Howard AF. (2009) Phase II trial of single-agent bevacizumab followed by bevacizumab plus irinotecan at tumor progression in recurrent glioblastoma. J Clin Oncol 27(5):740–745

    Article  Google Scholar 

  • Tomlinson FH, Scheithaur BW, Hayostek CJ et al (1994) The significance of atypia and histologic malignancy in pilocytic astrocytoma of the cerebellum. A clinicopathologic and flow cytometric study. J Neurooncol 9:301–310

    CAS  Google Scholar 

  • van den Bent MJ, Afra D, de Witt O, Ben Hassel M, Karim AB et al (2005) Long term efficacy of early versus delayed radiotherapy for low grade astrocytoma and oligodendroglioma in adults: the EORTC 22845 randomized trial. Lancet 366(9490):985–990

    Article  PubMed  Google Scholar 

  • van den bent MJ, Taphoorn MJB, Brandes AA, Menten J, Gorlia T et al (2003a) Phase II study of first line chemotherapy with temozolomide in recurrent oligodendroglial tumors: The European Organization for research and treatment of cancer Brain tumor group study 26971. J Clin Oncol 21(13):2526–2528

    Article  Google Scholar 

  • van den Bent MJ, Chinot O, Boogerd W, Bravo Marques J, Baron B et al (2003b) Second-line chemotherapy with temozolomide in recurrent oligodendroglioma after PCV (procarbazine, lomustine and vincristine) chemotherapy: EORTC brain tumor group phase II study 26972. Ann Oncol 14:599–602

    Article  PubMed  Google Scholar 

  • van den Bent MJ, Chinot OL, Cairncross JG (2003c) Recent developments in the molecular characterization and treatment of oligodendroglial tumors. Neuro Oncol. 5:128–138

    PubMed  Google Scholar 

  • Vredenburgh JJ, Desjardins A, Herndon JE, Friedman HS et al (2007) Bevacizumab plus Irinotecan in recurrent glioblastoma multiforme. J Clin Oncol 25(30):4722–4729

    Article  CAS  PubMed  Google Scholar 

  • Walker MD, Alexander E Jr, Hunt WE, Maccarty CS, Strike TA et al (1978) Evaluation of BCNU and/or radiotherapy in the treatment of anaplastic gliomas. A cooperative clinical trial. J Neurosurg 49(3):333–343

    Article  CAS  PubMed  Google Scholar 

  • Warnick RE, Pradis MD, Mack EE, Chandler KL, Doz E, Rabbitt JE, Malec MK (1994) A phase II study of intravenous carboplatin for treatment of recurrent gliomas. J Neurooncol 19(1):69–74

    Article  CAS  PubMed  Google Scholar 

  • Westphal M, Hilt DC, Bortey E, Delavaultr P, Ram Z et al (2003) A phase 3 trial of local chemotherapy with biodegradable carmustine (BCNU) wafers (Gliadel wafers) in patients with primary malignant glioma. Neuro Oncol 5:79–88

    CAS  PubMed  Google Scholar 

  • Westphal M, Ram Z, Riddle V, Hilt D, Bortey E (2006) Gliadel wafer in initial surgery for malignant glioma: long term follow up of a multi-center controlled trial. Acta Neurochir (Wien) 148:264–275

    Article  Google Scholar 

  • Wick W, Weller M et al (2008) Randomized phase III study of sequential radiochemotherapy of oligoastrocytic tumors of WHO-grade III with PCV or temozolomide: NOA-04. J Clin Oncol 26:90s abstr LBA2007

    Article  Google Scholar 

  • Wiestler OD, Lopes BS, Green AJ (2000) Pathology and genetics of tumors of the nervous system. IARC, Lyon, France, pp 227–230

    Google Scholar 

  • Wrensch M, Yuriko M, Chew T, Bondy M, Berger MS (2002) Epidemiology of primary brain tumors: current concepts and review of the literature. Neuro Oncol 4:278–299

    PubMed  Google Scholar 

  • Yung WK, Mechtler L, Gleason MJ (1981) Intravenous carboplatin for recurrent malignant glioma: a phase II study. J Clin Oncol 9(5):860–864

    Google Scholar 

  • Zhu G, Mehler MF, Mabie PC, Kessler JA (1999) Developmental changes in progenitor cell responsiveness to cytokines. J Neurosci Res 56:131–145

    Article  CAS  PubMed  Google Scholar 

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Moore, K., Kim, L. (2010). Primary Brain Tumors: Characteristics, Practical Diagnostic and Treatment Approaches. In: Ray, S. (eds) Glioblastoma. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0410-2_2

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