Recurrent Adult Brain Tumors
SurgeryRe-resection of recurrent brain tumors is used in some patients. However, the majority of patients do not qualify because of a deteriorating condition or technically inoperable tumors. The evidence is limited to noncontrolled studies and case series on patients who are healthy enough and have small enough tumors to technically debulk. The impact of reoperation versus patient selection on survival is not known.Localized ChemotherapyCarmustine wafers have been investigated in the setting of recurrent malignant gliomas, but the impact on survival is less clear than at the time of initial diagnosis and resection. In a multicenter randomized, placebo-controlled trial, 222 patients with recurrent malignant primary brain tumors requiring reoperation were randomly assigned to receive implanted carmustine wafers or placebo biodegradable wafers. Approximately half of the patients had received prior systemic chemotherapy. The two treatment groups were well balanced at baseline.
Adrenocorticotropic Hormone-Producing Pituitary Tumors Treatment
Standard Treatment Options for Adrenocorticotropic Hormone (ACTH)-Producing Pituitary TumorsStandard treatment options for ACTH-producing pituitary tumors include the following:Surgery (usually a transsphenoidal approach).[1,2,3]Surgery plus radiation therapy.[1,2,4]Radiation therapy.[1,2,4]Steroidogenesis inhibitors, including mitotane, metyrapone, ketoconazole, and aminoglutethimide.[1,2,5]For patients with corticotroph adenomas, transsphenoidal microsurgery is the treatment of choice.[1,2] Remission rates reported in most series are approximately 70% to 90%. In a series of 216 patients, who were operated on using a transsphenoidal approach, 75% experienced long-term remission, 21% experienced persistence of Cushing disease, and 9% had recurrence after the initial correction of the hypercortisolism. The average time interval for reoperation was 3.8 years. Seventy-nine percent of the tumors were microadenomas, and 18% were macroadenomas; 86% of the cases with microadenoma had
General Information About Childhood Brain Stem Glioma
Childhood brain stem glioma is a disease in which benign (noncancer) or malignant (cancer) cells form in the tissues of the brain stem. The brain stem is the part of the brain connected to the spinal cord. It is located in the lowest part of the brain,just above the back of the neck. The brain stem is the part of the brain that controls breathing,heart rate,and nerves and muscles used in ...
About This PDQ Summary
PURPOSE OF THIS SUMMARY This PDQ cancer information summary for health professionals provides comprehensive,peer-reviewed,evidence-based information about the treatment of adult brain tumors. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions. REVIEWERS AND ...
PDQ IS A COMPREHENSIVE CANCER DATABASE AVAILABLE ON NCI'S WEB SITE. PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health,the federal government's focal point for biomedical research. ...
Treatment Option Overview
There are different types of treatment for children with brain and spinal cord tumors. Different types of treatment are available for children with brain and spinal cord tumors. Some treatments are standard (the currently used treatment),and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information ...
The treatment section of this document is organized to correspond with the Children’s Oncology Group (COG) risk-based schema for the treatment of neuroblastoma. This schema is based on 3 factors: patient age at diagnosis,certain biological characteristics of the patient’s neuroblastoma tumor,and the stage of the tumor as defined by the International Neuroblastoma Staging System (INSS). The .
This cancer treatment information summary provides an overview of the prognosis,diagnosis,classification,and treatment of neuroblastoma. The National Cancer Institute provides the PDQ pediatric cancer treatment information summaries as a public service to increase the availability of evidence-based cancer information to health professionals,patients,and the public. These summaries are ...
General Information About Pituitary Tumors
Pituitary tumors represent from 10% to 25% of all intracranial neoplasms. Depending on the study cited, pituitary tumors can be classified into three groups according to their biological behavior:[1,2]Benign adenoma.Invasive adenoma.Carcinoma. Adenomas comprise the largest portion of pituitary neoplasms with an overall estimated prevalence of approximately 17%. Only a minority of adenomas are symptomatic. In addition, pituitary adenomas may be distinguished anatomically as intrapituitary, intrasellar, diffuse, and invasive. Invasive adenomas, which account for approximately 35% of all pituitary neoplasms, may invade the dura mater, cranial bone, or sphenoid sinus. Carcinomas account for 0.1% to 0.2% of all pituitary tumors.[6,7]Clinical PresentationThe most characteristic-presenting features of pituitary adenomas include inappropriate pituitary hormone secretion and visual field deficits.Rare signs and symptoms of pituitary disease include:Cranial nerve palsies.Temporal
Stage Information and Treatment of Newly Diagnosed and Recurrent Childhood Spinal Cord Tumors
There is no uniformly accepted staging system for childhood primary spinal cord tumors. These tumors are classified and treated based on their location within the spinal cord and histology. Refer to one of the following PDQ summaries for more information on the staging and treatment of newly diagnosed and recurrent childhood spinal cord tumors:Childhood Astrocytomas Treatment.Childhood Central Nervous System Embryonal Tumors Treatment.Childhood Ependymoma Treatment.In general, at the time of recurrence, low-grade spinal cord glial tumors can be treated with re-resection with or without the use of radiation therapy. Recurrent low-grade and high-grade tumors that cannot be re-resected can be treated on protocols designed for histologically similar brain tumors.