Brain stem gliomas have relatively poor prognoses that correlate with histology (when biopsies are performed), location, and extent of tumor. The overall median survival time of patients in studies has been 44 to 74 weeks.[1,2,3,4,5] The best results have been attained with hyperfractionated radiation therapy.[5]

STANDARD TREATMENT OPTIONS:

• Radiation therapy.[1,2,3,4,5,6]

TREATMENT OPTIONS UNDER CLINICAL EVALUATION:

• At recurrence, patients should be considered for clinical trials that evaluate new drugs and biological response modifiers.[7,8]

Information about ongoing clinical trials is available from the NCI Web site.

References:

1. Greenberger JS, Cassady JR, Levene MB: Radiation therapy of thalamic, midbrain and brain stem gliomas. Radiology 122 (2): 463-8, 1977.
2. Levin VA, Edwards MS, Wara WM, et al.: 5-Fluorouracil and 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) followed by hydroxyurea, misonidazole, and irradiation for brain stem gliomas: a pilot study of the Brain Tumor Research Center and the Childrens Cancer Group. Neurosurgery 14 (6): 679-81, 1984.
3. Allen JC, Bloom J, Ertel I, et al.: Brain tumors in children: current cooperative and institutional chemotherapy trials in newly diagnosed and recurrent disease. Semin Oncol 13 (1): 110-22, 1986.
4. Eifel PJ, Cassady JR, Belli JA: Radiation therapy of tumors of the brainstem and midbrain in children: experience of the Joint Center for Radiation Therapy and Children's Hospital Medical Center (1971-1981). Int J Radiat Oncol Biol Phys 13 (6): 847-52, 1987.
5. Shrieve DC, Wara WM, Edwards MS, et al.: Hyperfractionated radiation therapy for gliomas of the brainstem in children and in adults. Int J Radiat Oncol Biol Phys 24 (4): 599-610, 1992.
6. Surma-aho O, Niemelä M, Vilkki J, et al.: Adverse long-term effects of brain radiotherapy in adult low-grade glioma patients. Neurology 56 (10): 1285-90, 2001.
7. Fulton DS, Levin VA, Wara WM, et al.: Chemotherapy of pediatric brain-stem tumors. J Neurosurg 54 (6): 721-5, 1981.
8. Rodriguez LA, Prados M, Fulton D, et al.: Treatment of recurrent brain stem gliomas and other central nervous system tumors with 5-fluorouracil, CCNU, hydroxyurea, and 6-mercaptopurine. Neurosurgery 22 (4): 691-3, 1988.