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High-grade gliomas.

Brett J Theeler1, Morris D Groves

  • 1Department of Neuro-Oncology, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 0431, Houston, TX, 77030-4009, USA.

Current Treatment Options in Neurology
|April 19, 2011
PubMed
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High-grade gliomas require maximal surgical resection and radiotherapy. Standard treatment for glioblastoma involves concurrent and adjuvant temozolomide (TMZ), while chemotherapy roles in anaplastic gliomas are still evolving.

Area of Science:

  • Neuro-oncology
  • Radiation Oncology
  • Medical Oncology

Background:

  • High-grade gliomas (HGGs) necessitate aggressive treatment strategies.
  • Current standards involve surgery, radiotherapy, and chemotherapy, with evolving roles for specific agents.
  • Optimal management for recurrent or anaplastic gliomas remains an area of active investigation.

Purpose of the Study:

  • To outline current treatment paradigms for high-grade gliomas.
  • To discuss the role of radiotherapy and chemotherapy, including temozolomide (TMZ) and procarbazine, lomustine, vincristine (PCV).
  • To highlight the importance of clinical trials and molecularly targeted therapies for HGGs.

Main Methods:

  • Review of established treatment protocols for newly diagnosed and recurrent HGGs.

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  • Discussion of standard-of-care regimens including surgery, radiotherapy (57-60 Gy), and chemotherapy (TMZ, PCV).
  • Consideration of emerging therapies and the importance of molecular profiling.
  • Main Results:

    • Maximal safe surgical resection followed by radiotherapy is the cornerstone for HGGs.
    • Concurrent and adjuvant temozolomide (TMZ) is standard for newly diagnosed glioblastoma.
    • Chemotherapy's role in anaplastic gliomas and recurrent glioblastoma requires further clarification, with bevacizumab and dose-intense TMZ as options.

    Conclusions:

    • Treatment for HGGs integrates surgery, radiotherapy, and chemotherapy, with TMZ being central for glioblastoma.
    • Further research is needed to define optimal chemotherapy strategies for anaplastic gliomas and recurrent disease.
    • Future directions emphasize molecularly targeted agents and clinical trial participation for all HGG patients.