High grade astrocytomas such as Anaplastic astrocytoma and
Glioblastoma multiforme infiltrate surrounding brain tissue and, therefore,
complete surgical removal is usually not possible. These cancers are usually
fatal although prolonged survival does occur in a small minority of patients.
Radiation after surgery prolongs survival for a few months.
The roles of sterotaxic radiosurgery and interstital brachytherapy are
uncertain. Sterotaxic radiosurgery is the administration of a highly focused
dose of radiation. Examples of this include gamma knife. Interstital brachytherapy
is the placement of radioactive material directly into the tumor. This
approach is associated with necrosis (i.e. death) of normal brain tissue.
Chemotherapy is only marginally effective in the treatment
of Anaplastic astrocytoma and Glioblastoma multiforme. Typical chemotherapy
agents include carmustine (BCNU) and lomustine (CCNU).
Today, there are some encouraging published results with
immunotherapy and biologic therapies (i.e. radio-immunotherapy, retinoid
therapy, and vitamin analogs). The Cancer Monthly database currently has
the results (survival, side effects, etc.) for 100 recent therapies for
glioblastoma multiforme and 22 recent therapies for anaplastic astrocytoma
including: immunotherapy, gene therapy, biological therapy, radiation,
surgery, chemotherapy, and hormone therapy.
Source: Stephen M. Sangar and Mark A. Israel, Primary
and Metastatic Tumors of the Nervous System, in HARRISON'S PRINCIPLES
OF INTERNAL MEDICINE, pt. 15 § 358, at 2452-2460 (Dennis L. Kasper,
M.D. et al., eds, 16th ed 2005).