Pathologic tumor type and response to treatment

The general biology of the common primary brain tumors is reviewed, as are the results of surgery, radiation therapy, and chemotherapy for these neoplasms. The problems of classification, particularly of the astrocytomas, are noted, with the resultant difficulties in comparing different series. The development and consistent application of a widely acceptable nomenclature for brain tumors would be useful in the comparison of various therapies and for ease in communication. Further, a better general understanding of the biology of the various brain tumors is desirable. Reliable data relative to old or new forms of therapy seem to require national or regional studies in view of the relative rarity of some of these tumors. Except for medulloblastoma, the best results of therapy thus far are only slightly encouraging. We must also be aware that some of our treatments may do as much harm to some patients as their tumors; therefore, we must all strive for a high autopsy rate so that we can monitor our therapy and recognize unexpected complications as quickly as possible.