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Semin Neurol 2023; 43(06): 889-896
DOI: 10.1055/s-0043-1776764
Review Article

Neuro-oncology Treatment Strategies for Primary Glial Tumors

Fernando Santos-Pinheiro
1   Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
,
Jerome J. Graber
2   Department of Neurology and Neurosurgery, University of Washington, Alvord Brain Tumor Center, Seattle, Washington
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Abstract

Primary brain tumors underwent reclassification in the 2021 World Health Organization update, relying on molecular findings (especially isocitrate dehydrogenase mutations and chromosomal changes in 1p, 19q, gain of chromosome 7 and loss of chromosome 10). Newer entities have also been described including histone 3 mutant midline gliomas. These updated pathologic classifications improve prognostication and reliable diagnosis, but may confuse interpretation of prior clinical trials and require reclassification of patients diagnosed in the past. For patients over seventy, multiple studies have now confirmed the utility of shorter courses of radiation, and the risk of post-operative delirium. Ongoing studies are comparing proton to photon radiation. Long term follow up of prior clinical trials have confirmed the roles and length of chemotherapy (mainly temozolomide) in different tumors, as well as the wearable novottf device. New oral isocitrate dehydrogenase inhibitors have also shown efficacy in clinical trials.

Keywords

brain tumor - glioblastoma - astrocytoma - oligodendroglioma - brain cancer


Publication History

Article published online:
14 December 2023

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