Universität zu Köln

Goldbrunner, Roland, Ruge, Maximilian, Kocher, Martin, Lucas, Carolin Weiss, Galldiks, Norbert ORCID: 0000-0002-2485-1796 and Grau, Stefan (2018). The Treatment of Gliomas in Adulthood. Dtsch. Arztebl. Int., 115 (20-21). S. 356 - 366. COLOGNE: DEUTSCHER AERZTE-VERLAG GMBH. ISSN 1866-0452

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Abstract

Background: Gliomas are the most common intrinsic tumors of the brain, with an incidence of 6 per 100 000 persons per year. Recent years have seen marked changes in the diagnosis and treatment of gliomas, with molecular parameters now being an integral part of the diagnostic evaluation. Methods: This review is based on pertinent articles retrieved by a selective search in PubMed, with special attention to the new WHO glioma classification. Results: The classification of gliomas on the basis of additional molecular parameters enables more accurate prognostication and serves as a basis for therapeutic decision-making and treatment according to precisely specified algorithms. PET scanning with F-18-fluoroethyl tyrosine and C-11-methionine for the measurement of metabolic activity in gliomas has further refined the diagnostic evaluation. The median overall survival of patients with glioblastoma who have undergone resection of all tumor tissue with a disrupted blood-brain barrier (i.e., all contrast-enhancing tumor tissue) has been prolonged to up to 20 months. The 5-year survival of patients with WHO grade II gliomas is now as high as 97% after near-total resection. The surgical resection of all contrast-enhancing tumor tissue and subsequent radiotherapy and chemotherapy remain the key elements of treatment. New surgical strategies and new methods of planning radiotherapy have made these techniques safer and more effective. The percutaneous application of tumor-treating fields is a new therapeutic option that has gained a degree of acceptance. Accompanying measures such as psycho-oncology and palliative care are very important for patients and should be considered mandatory. Conclusion: The consistent application of the existing multimodal treatment options for glioma has led in recent years to improved survival. Areas of important current and future scientific activity include immunotherapy and targeted and combined chemotherapy, as well as altered neurocognition, modern approaches to palliative care, and complementary therapies.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Goldbrunner, Roland UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruge, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Kocher, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Lucas, Carolin Weiss UNSPECIFIED UNSPECIFIED UNSPECIFIED Galldiks, Norbert UNSPECIFIED orcid.org/0000-0002-2485-1796 UNSPECIFIED Grau, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-186061
DOI:	10.3238/arztebl.2018.0356
Journal or Publication Title:	Dtsch. Arztebl. Int.
Volume:	115
Number:	20-21
Page Range:	S. 356 - 366
Date:	2018
Publisher:	DEUTSCHER AERZTE-VERLAG GMBH
Place of Publication:	COLOGNE
ISSN:	1866-0452
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LOW-GRADE GLIOMA; NEWLY-DIAGNOSED GLIOBLASTOMA; NEUROONCOLOGY WORKING GROUP; PHASE-III TRIAL; EUROPEAN ASSOCIATION; RESPONSE ASSESSMENT; O-(2-F-18-FLUOROETHYL)-L-TYROSINE PET; TEMOZOLOMIDE CHEMOTHERAPY; STEREOTACTIC BIOPSY; BRAIN-TUMORS Multiple languages Medicine, General & Internal Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18606