Anaplastic astrocytoma in adults
Roger Stupp1, Michele Reni, Gemma Gatta
1University Hospital (CHUV), Lausanne, Switzerland. Roger.Stupp@chuv.ch
Critical Reviews in Oncology/Hematology
|May 5, 2007
Summary
Anaplastic astrocytoma treatment remains challenging, with limited chemotherapy benefits. Postoperative radiotherapy is standard, while temozolomide shows promise for recurrent disease.
Area of Science:
- Neuro-oncology
- Adult oncology
Background:
- Anaplastic astrocytoma is rare in adults.
- Prognosis depends on age, symptom duration, mental status, and Karnofsky performance status.
- Complete surgical resection is often impossible, leading to common recurrence.
Purpose of the Study:
- To review the current understanding and treatment of anaplastic astrocytoma.
- To evaluate the efficacy of different therapeutic modalities.
Main Methods:
- Review of available randomized data and meta-analyses on chemotherapy.
- Discussion of standard adjuvant radiotherapy protocols.
- Analysis of phase II trial data for temozolomide in recurrent disease.
Main Results:
- Chemotherapy has generally failed to improve outcomes in randomized trials.
- A meta-analysis indicated a small survival benefit with chemotherapy.
- Postoperative radiotherapy (30 x 2 Gy) is the standard adjuvant therapy.
- Temozolomide is active and well-tolerated in phase II trials for recurrent anaplastic astrocytoma.
Conclusions:
- Treatment for anaplastic astrocytoma is complex, with limited options for improving survival.
- Radiotherapy is the established standard adjuvant treatment.
- Further comparative trials are needed for recurrent disease, but temozolomide is a viable option.
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