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Glioma: Principles and Practice in Neuro-Oncology PDF

291 Pages·1991·18.6 MB·English
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A. B. M. F. Karim E. R. Laws, Jr. (Eds.) GLIOMA Principles and Practice in Neuro-Oncology With 62 Figures and 38 Tables Springer-Verlag Berlin Heidelberg New York London Paris Tokyo Hong Kong Barcelona Budapest Dr. A. B. M. F. Karim Department of Radiation Oncology, Free University Hospital, P.O. Box 7057, The Netherlands 1007 MB Amsterdam Dr. Edward R. Laws, Jr. Department of Neurological Surgery, George Washington University Medical Center, 2150 Pennsylvania Ave. NW, Washington DC 20037, USA ISBN -13: 978-3-540-52286-7 e-ISBN -13: 978-3-642-84127-9 DOl: 10.1007/978-3-642-84127-9 Library of Congress Cataloging-in-Publication Data Glioma: principles and practice in neuro-oncology 1 A.B.M.F. Karim, E.R. Laws, Jr. (eds.). Includes index. ISBN-I3: 978-3-540-52286-7 1. Gliomas. I. Karim; Abul Bashr Mohammed FazluI. II. Laws, Junior, Edward R. [DNLM: 1. Brain Neoplasms - diagnosis. 2. Brain Neoplasms-therapy. 3. Glioma. WL 358 G5607] RC280.B7G581991 616.99'281-dc20 DNLM/DLC for Library of Congress 91-4599CIP . This work is subject to copyright. AIl rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, re-use of illustra- tions, recitation, broadcasting, reproduction on microfilms or in other ways, and storage in data banks. Duplication of this publication or parts thereof is ouly permitted under the provisions of the German Copyright Law of September 9, 1965, in its current version, and a copyright fee mnst always be paid. © Springer-Verlag Berlin Heidelberg 1991 The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protec- tive laws and regulations and therefore free for general use. Product liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature. Typesetting: Briihlsche U niversitiitsdruckerei, Giessen 27/3020-543210- Printed on acid-free paper Preface Many recent developments in neuro-oncology relevant to clinical practice have contributed to improved patient care. The most im- portant impact of these developments on treatment may have been a change in the attitudes of the neuro-oncologists involved in making decisions regarding patients with gliomas. From an era of uncertainty which led to therapeutic nihilism, we have entered one of active interventions based on objective parameters for the treat- ment of gliomas, which may be either slow-growing or rapid kil- lers. The histopathological characteristics of gliomatous lesions are intriguing, and it is only recently that a clearer picture has begun to emerge. A group of dedicated neuropathologists has been at- tempting to reach a consensus on pathological classification and grading, providing an important landmark in the field of neuro- oncology. This book does not mean to provide exhaustive details on the histopathology of gliomas, but rather highlights the main problems in an authoritative chapter. This chapter attempts to guide the reader to a better understanding of all aspects of the neuropathology of glioma. Neuroradiology has recently seen several breakthroughs. Im- ages unimaginable a decade ago are now providing us with an al- most three-dimensional impression. But the concomitant illusions and artifacts must also be kept in mind, and pragmatic ideas are carefully put forward in this book about the developing body of knowledge concerning the newer imaging techniques. In other chapters of this book, prominent authors have reviewed their experiences with multimodal approaches to treat- ment of gliomas and their results. Although at the present state of knowledge controversies on the topic of treatment are not totally avoidable, a broad consensus has crystallized. The logical discus- sions in this volume will help the reader to formulate policies in the 4ay-to-day treatment of patients with gliomas. The chapters on treatment include virtually all innovative treatment methodologies with promise, hopefully enabling the reader to get consistent help. The most renowned workers in their fields have updated their own and other available data on surgery, radiotherapy, and chemotherapy for both adult and childhood gliomas in various chapters in this book. Others deal with the role VI Preface of hypoxic sensitizers, steroid hormones, stereotactic interstitial or external therapy in primary or recurrent tumors, and boron- neutron capture therapy. The damage to normal brain tissues as- sociated with these experimental forms of therapy is given major emphasis. Sometimes a slowly growing lesion changes course by dedifferentiation and becomes the most virulent of malignancies. This can happen both with untreated primary gliomas and with tumor remnants after treatment. This book also contains a chap- ter from an authority on the fate of these tumors. The question of cure of patients with gliomas and the quality of life after cure has very rarely been confronted in neuro- oncology. A chapter on this topic unfolds the realities and indi- cates future directions. The last word on treatment cannot be spoken as yet, but such a diversity of topics as is covered here has not recently been dealt with together in one volume. Our purpose is to provide the reader with a book from which guidelines may be obtained for better patient care. Amsterdam, A.B.M.F.Karim, MD, FRCR, PhD January 1991 E.R.Laws, Jr, MD, FACS Contributors Afra,D. National Institute of Neurosurgery, Amerikai lit 57,1145 Budapest, Hungary Alphen, van H. A. M. Department of Neurosurgery, Free University Hospital, Postbus 7057,1007 MB Amsterdam, The Netherlands Bleehen, N. M. University Departmentand Medical Research Council Unit of Clinical Oncology and Radiotherapeutics, Addenbrookes Hospital, Hills Road, Cambridge CB22QQ, United Kingdom Chierego, G. Department of Medical Physics, City Hospital, Viale Rodolfi, 36100 Vicenza, Italy Colombo,F. Department ofNe urosurgery, City Hospital, Viale Rodolfi, 36100 Vicenza, Italy Fankhauser, H. Neurosurgical Service, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland Ghibbeke, van M. Statistician, EORTC Data Centre, Avenue E. Mounier 83-B11, 1200 Brussels, Belgium Gonzalez, D. G. Department of Radiation Oncology, Academic Medical Centre, Meibergdreef9, 1105 AZ Amsterdam, The Netherlands Guthrie, B. L. Department of Neurosurgery, George Washington University Medical Center, 2150 Pennsylvania Avenue, N. W., Washington, DC 20037, USA VIII Contributors Gutin,P.H. Department of Neurological Surgery, Long Hospital, Room L75, University of California, San Francisco, California 94143-0226, USA Hatanaka, H. Department of Neurosurgery, Teikyo Univ. School of Medicine, 11-1 Kaga 2-chome, Itabashi-ku, Tokyo 173, Japan Kaiser, M. C. Service de Radiologie, Clinique Sacn~-Coeur, 48A, Avenue Gaston Diderich, 1420 Luxembourg-Ville, Luxembourg Karim, A. B. M. F. Department of Radiation Oncology, Free University Hospital, Postbus 7057,1007 MBAmsterdam, The Netherlands Kim,T.H. Division of Pediatric Hematology and Oncology, Emory University, Atlanta, Georgia, USA Kogel, van der A. J. Sint-Radboudziekenhuis, Instituut voor Radiotherapie, University of Nijmegen, Geert Grooteplein Zuid 32, 6525 GA Nijmegen, The Netherlands Kralendonk, J. H. Department of Radiation Oncology, Free University Hospital, Postbus 7057; 1007 MB Amsterdam, The Netherlands Larson, D. A., Department of Radiation Oncology, Long Hospital, Room L 75, University of California, San Francisco, California 94143-0226, USA Laws, Jr. E. R. Department of Neurosurgery, George Washington University Medical Center, 2150 Pennsylvania Avenue, N. W., Washington, DC 20037, USA Marchetti, C. Department of Medical Physics, City Hospital, Viale Rodolfi, 36100 Vicenza, Italy Miiller, W. Pathologisches Institut der U niversitat zu K61n, Abteilung Neuropathologie, 5000 K61n, FRG Contributors IX Nordman,E. Department of Oncology and Radiotherapy, University ofTurku, Kiinamyllynkatu 4-8, 20520 Turku 52, Finland Ostertag C. B. Abteilung Stereotaktische Neurochirurgie, Hugstetter Str. 55,7800 Freiburg i. Br., FRG Pozza,F. Department of Radiotherapy, City Hospital, Viale Rodolfi, 36100 Vicenza, Italy Ragab,A.H. Division of Pediatric Hematology and Oncology, Emory University, Atlanta, Georgia, USA Rao,B.R. Department of Endocrinology, Free University Hospital, Postbus 7057, 1007 MB Amsterdam, The Netherlands Razek,A. Therapy Associates Inc., 906 S. Hebron, Box 15040, Evansville, Indiana 477160-0040, USA Roelvink, N. C. A Ostwalt 5, 4290 Bocholt, FRG Rutten, E. H. J. M. Department of Radiotherapy, University Hospital St. Radboud, Geert Grooteplein Zuid 32, 6500 HB Nijmegen, The Netherlands Schueren, van der E. Department of Oncology, University Hospital Sint Rafael, Capucijnenvoer 33, 3000 Leuven, Belgium Slotman, B.J. Department of Endocrinology, Free University Hospital, Postbus 7057, 1007 MB Amsterdam, The Netherlands Sneed,P.K. Department of Radiation Oncology, Long Hospital, Room L75, University of California, San Francisco, California 94143-0226, USA Stam,F.C. Department of Neuropathology, Free University Hospital, Postbus 7057,1007 MB Amsterdam, The Netherlands x Contributors Thomas, D. G. T. Department of Neurological Surgery, Institute of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London WCl E 3BG, United Kingdom Tribolet, de N. Neurosurgical Service, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland Contents Pitfalls and Controversies in the Treatment of Gliomas A.B.M.F. KarimandJ.H. Kralendonk. . . . . . . 1 The Problems of Pathological Diagnosis F.C. Stam . . . . . . . . . . . . . . . . . . . . . 17 M,odern Imaging for Cerebral Gliomas: Breakthroughs and Limitations M. C. Kaiser and J. H. I(ralendonk. . . ....... 37 The Impact of Modern Imaging Techniques on the Policy for Treating Cerebral Gliomas H. A. M. van Alphen . . . . . . . . . . ... 57 Management of Supratentorial Low-Grade Gliomas B.L. Guthrie and E.R. Laws. . . . . . . . . . . 75 Surgery in the Treatment of Malignant Glioma: Current Status and Future Perspectives N. de Tribolet and H. Fankhauser. . .. ...... 93 Evolution of Modern Radiation Therapy in the Treatment of Gliomas E. Nordman. . . . . . . . . .. ........ 107 Raqiotherapy for Malignant Gliomas A.B.M.F. Karim, E. van der Schueren, D. G. Gonzalez, and M. van Glabbeke. . . . . . . . . . . . . . .. . 121 Stereotactic Interstitial Radiotherapy in the Treatment of Gliomas: Current Status, Results, and the Future C. B,. Ostertag. . . . . . . . . . . . . .. ... 125 Stereotactic External Radiotherapy for Gliomas: Techniques, Dosimetry, Results F. Pozza, F. Colombo, C. Marchetti, and G. Chierego . 139 Hypoxic Cell Sensitizers in the Management of Brain Tumors N. M. Bleehen. . . . . . . . . . . . . . . . . . . . 153

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