Treatment For Volume Upgrading of the Low-Grade Supratentorial Glioma After the Subtotal Neurosurgical Resection

Česká verzia

Authors: F. Třebický ¹; J. Kubeš ¹; R. Bartoš ²; A. Malucelli ²; M. Sameš ²; M. Navrátil ³; V. Vondráček ³; S. Medková ³; M. Mašek ⁴; J. Zárubová ⁵
Authors place of work: Ústav radiační onkologie, 1. LF UK a Nemocnice Na Bulovce, Praha ¹; Neurochirurgická klinika, UJEP a Masarykova nemocnice v Ústí nad Labem ²; Radiofyzikální oddělení, 1. LF UK a Nemocnice Na Bulovce, Praha ³; Radiodiagnostická klinika, 1. LF UK a Nemocnice Na Bulovce, Praha ⁴; Neurologická klinika, Thomayerova nemocnice, Praha ⁵
Published in the journal: Klin Onkol 2012; 25(4): 294-298
Category: Kazuistiky

Summary

Background:
Low-grade gliomas WHO II (LGG) are mostly detected in patients with neurological symptomatology between 20 and 45 years of age very often as secondary epilepsy. We present two cases in which low-grade gliomas attacked neurological zones. Neurosurgical resection was subtotal because of the risk of the damage in neurocognitive functions in both these patients. After the operation, both patients were followed at neurosurgery department in regular intervals using different imaging methods (MRI, MRS and PET). After resections, the MRI detected the enlargement of the volumes of the tumor residua in both patients.

Patients and methods:
Owing to the risk of up-grading to high-grades glial tumors (overexpression of EGFR and VEGF), both patients were indicated for curative treatment by external beam radiotherapy combined with chemotherapy (Temodal^®) and adjuvant chemotherapy.

Results:
After the end of this treatment, the MRI proved considerable partial regressions in both patients. Moreover, three months later, the MRI did not prove any residual disease.

Conclusion:
Radiotherapy combined with the administration of Temodal should prolong the OS and TTP in patients with a high risk of up-grading of low-grade gliomas of the brain. Both the patients are in a follow-up program, also because of the risk of duplicite brain tumor.

Key words:
brain tumor – glioma – tumor grading – chemotherapy – temozolomide – radiotherapy

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Submitted:
7. 12. 2011

Accepted:
27. 7. 2012

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