Skip to main content

Advertisement

Log in

Therapeutic strategies for local recurrent malignant glioma

  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

Opinion statement

Patients with local recurrent malignant gliomas present diagnostic and therapeutic challenges for the neuro-oncology practitioner. Management must be individualized depending on the patient’s age, performance status, histology, response to initial therapy, type of recurrence (local vs diffuse), and time since original diagnosis. Treatment options may be classified into surgery, additional radiation therapy, or chemotherapy. Results of treatment are often difficult to determine because of limitations of conventional imaging. Symptom palliation is an important goal that often requires additional adjuvant medical therapy. Quality of life issues are also of paramount importance in patients with recurrent malignant glioma and frequently will guide management strategy. Finally, patients with recurrent malignant gliomas should be encouraged to consider participation in a clinical trial in the hopes that better treatment alternatives will be available for this group of patients within the next few years.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Lee SW, Fraass BA, Marsh LH, et al.: Patterns of failure following high-dose 3-D conformal radiotherapy for high-grade astrocytomas: a quantitative dosimetric study. Int J Radiat Oncol Biol Phys 1999, 43:79–88.

    PubMed  CAS  Google Scholar 

  2. Lacroix M, Abi-Said D, Fourney DR, et al.: A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival. J Neurosurg. 2001 95(2):190–8. Important data showing immediate postoperative assessment of resection correlates with overall survival.

    Article  PubMed  CAS  Google Scholar 

  3. Albert FK, Forsting M, Sartor K, et al.: Early postoperative magnetic resonance imaging after resection of malignant glioma: objective evaluation of residual tumor and its influence on regrowth and prognosis. Neurosurgery 1994, 34:45–60; discussion 60–61.

    Article  PubMed  CAS  Google Scholar 

  4. Curin WJ, Scott CB, Horton J, et al.: Recursive partitioning analysis of prognostic factors in three radiation therapy oncology group malignant glioma trials. J Natl Cancer Inst 1993, 85:704–710.

    Article  Google Scholar 

  5. Shaw E, Scott C, Souhami L, et al.: Single-dose radiosurgical treatment of recurrent previously irradiated primary brain tumor and bone metastases: final report of Radiation Therapy Oncology Group May 05. Int J Radiat Oncol Biol Phys 2000, 47:291–298.

    Article  PubMed  CAS  Google Scholar 

  6. Halligan JB, Stelzer KJ, Rostomily RC, et al.: Operations in permanent low activity 125 I brachytherapy for recurrent high-grade astrocytomas. Int J Radiat Oncol Biol Phys 1996, 35:541–547.

    Article  PubMed  CAS  Google Scholar 

  7. Shrieve DC, Alexander E, Wen PY, et al.: Comparison of stereotactic radiosurgery and brachytherapy in the treatment of glioblastoma multiforme. Neurosurgery 1995, 36:275–284.

    Article  PubMed  CAS  Google Scholar 

  8. Gaspar LE, Zamorano LJ, Shamsa F, et al.: Permanent 125 iodine implants for recurrent malignant gliomas. Int J Radiat Oncol Biol Phys 1999, 43:977–982.

    Article  PubMed  CAS  Google Scholar 

  9. Tatter SB, Shaw EG, Rosenblum ML, et al.: An inflatable balloon catheter and liquid 125 I radiation source (GliaSite Radiation Therapy System) for treatment of recurrent malignant glioma: multicenter safety and feasibility trial. J Neurosurg 2003, 2:297–303.

    Google Scholar 

  10. Sanan A: Retrospective multicenter data: recurrent malignant gliomas. Paper presented at the 95th Annual Meeting of the American Association for Cancer Research. Orlando, Florida; March 27–31, 2004.

    Google Scholar 

  11. Walker MD, Green SV, Bial TP, et al.: Randomized comparison of radiotherapy in nitrosoureas for the treatment of malignant glioma after surgery. N Engl J Med 1980, 4:1323–1329.

    Article  Google Scholar 

  12. Medical Research Council Brain Tumor Working Party: Randomized trial of procarbazine, lomustine, and vincristine in the adjuvant treatment of high-grade astrocytoma. J Clin Oncol 2001, 19:509–518.

    Google Scholar 

  13. Stupp R, Mason WP, Van Den Bent MJ, et al.: Concomitant and adjuvant temozolomide (TMZ) and radiotherapy (RT) for newly diagnosed glioblastoma multiforme (GBM). American Society of Clinical Oncology annual meeting proceedings, 2004 [abstract]. J Clin Oncol 2004: 22(Suppl 2):14S. Conclusive results of a randomized phase III trial by the European Organisation for Research and Treatment of Cancer, Brain & Radiotherapy Groups, and National Cancer Institute of Canada Clinical Trials Group.

    Google Scholar 

  14. Combs SE, Gutwein S, Schulz-Ertner D, et al.: Temozolomide combined with radiation as first line treatment in primary glioblastoma multiforme: phase I/II study [abstract]. Proceedings of the American Society for Clinical Oncology. J Clin Oncol 2004, 22(Suppl 14):1531.

    Google Scholar 

  15. Valtonen S, Timonen U, Toivanen P, et al.: Interstitial chemotherapy with cremestine-loaded polymers for high-grade gliomas: a randomized double-blind study. Neurosurgery 1997, 41:44–48.

    Article  PubMed  CAS  Google Scholar 

  16. Subach BR, Witham TF, Kondziolka D, et al.: Morbidity and survival after 1, 3-bis (2-chloroethyl)-1 nitrosourea wafer implantation for recurrent glioblastoma: a retrospective case-matched cohort series. Neurosurgery 1999, 45:17–22.

    Article  PubMed  CAS  Google Scholar 

  17. Weaver M, Laske DW: Transferrin receptor ligandtargeted toxin conjugate (Tf-CRM107) for therapy of malignant gliomas. J Neurooncol 2003, 65:3–13.

    Article  PubMed  Google Scholar 

  18. NeoPharm and Collaborators: New IL13-PE3AQQR clinical data in brain cancer. Press release presented by NeoPharm Corporation, June 3, 2003.

  19. Wheeler CJ, Das A, Liu G, et al.: Clinical responsiveness of glioblastoma multiforme to chemotherapy after vaccination. Clin Cancer Res 2004, 10:5316–5326.

    Article  PubMed  CAS  Google Scholar 

  20. Glantz MJ, Cole BF, Forsythe PA, et al.: Practice parameter: anticonvulsant prophylaxis in patients with newly diagnosed brain tumors. Report of the quality standard subcommittee of the American Academy of Neurology. Neurology 2000, 54:18186–1893.

    Google Scholar 

  21. Villikka K, Kivisto KT, Maenpa AH, et al.: Cytochrome P450-inducing antiepileptics increase the clearance of vincristine in patients with brain tumors. Clin Pharmacol Ther 1999, 66:589–593.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sills, A.K., Duntsch, C. & Weimar, J. Therapeutic strategies for local recurrent malignant glioma. Curr. Treat. Options in Oncol. 5, 491–497 (2004). https://doi.org/10.1007/s11864-004-0037-z

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11864-004-0037-z

Keywords

Navigation