[Multimodality treatment of malignant brain tumors]

The outcome of treatment for malignant brain tumors has remarkably improved in recent years by applying multimodal therapeutic procedures. This conclusion was made by analysis of accurate data consisting 22,600 cases of completely followed brain tumor patients accumulated under the All Japan Brain Tumor Registry. The 5-years survival rates of malignant brain tumors have much improved in these 15 years, in which the most significant improvements were noticed in cases of medulloblastoma and intracranial germ cell tumors. The 5-year survival rate of medulloblastoma was improved from about 30% to more than 80%, and the number of cured patients are increasing. These favorable results are due to many factors, such as advanced imaging diagnosis of CT scan and MRI, radical surgical removal of tumors under operating microscope, and combined radiotherapy with chemotherapy. The synchronized chemoradiotherapy using vincristine and ACNU or ACNU and interferon has significantly improved the outcome of treatment for malignant gliomas. The administration of calcium entry blocker before the injection of vincristine has improved the effectiveness rates of chemoradiotherapy. Germinoma can completely be cured by chemoradiotherapy. The 5-year survival rates of germinoma have reached to 100% in female and more than 93% in male cases. The effectiveness of surgical removal, sensitivity for radiotherapy and chemotherapy were analyzed in various histological types of brain tumors and the significant effect of multimodal treatment for these tumors were discussed.