OBJECTIVE: Temozolomide is a novel oral alkylating agent, which has been reported to be effective in treating patients with recurrent malignant gliomas. This study report an analysis of the activity and toxicity of temozolomide as second-line therapy for patients with recurrent and progressive malignant gliomas after surgery and standard radiation therapy with or without chemotherapy. METHODS: Twenty patients with malignant gliomas of which thirteen(65%) had glioblastoma multiforme(GBM), five(25%) with anaplastic astrocytoma(AA), and two(10%) with anaplastic oligodendroglioma(AO) were enrolled in this study. They had been treated in our institution since July, 2000 and had been previously irradiated with or without chemotherapy. For the patients with recurrent and progressive disease, temozolomide(150-200mg/m2/d x5 days) was administered every 28 days until the progression of the tumor or toxicity developed. RESULTS: The median number of treatment cycles was 3(total 86). Of the 20 patients, 2(10%) achieved a complete response(CR), 5(25%) achieved a partial response(PR), 5(25%) had stable disease(SD), and 8(40%) had progressive disease(PD). One patient achieved a CR, 3 patients achieved a PR, 2 patients had SD and 7 patients had PD in GBM, and 1 patient achieved a CR, 2 patients achieved a PR, 3 patients had SD, 1 patient had PD in the non-GBM patients. Median progression free survival(PFS) was 8 weeks in GBM and 22 weeks in the non-GBM patients. No hematological toxicity greater than grade 2 was observed, and hepatotoxicity of grade 2 was encountered in 1(5%) patient. CONCLUSION: Temozolomide demonstrate moderate activity in recurrent and progressive malignant brain tumors, and the response rate and PFS were better in the non-GBM tumors than in the GBM tumors. The treatment is well tolerated without any serious toxicity.
Brain Neoplasms ; Drug Therapy* ; Glioblastoma ; Glioma* ; Humans

The authors have studied six patients with histologically proven primary malignant lymphoma of the brain which is still a rare primary brain tumor. The clinical, radiological and pathological findings with results of the treatment are presented. All cases showed a good response to radiation therapy. Therefore, the early diagnosis by computerized tomography scan followed by biopsy or excision is considered to be very important for the BEST results in the treatment. Related reports are discussed briefly.
Biopsy ; Brain Neoplasms ; Brain* ; Drug Therapy ; Early Diagnosis ; Humans ; Lymphoma*

A rare case of microgliomatosis(reticulum cell sarcoma) of the brain is reported. The tumor was located in the left parietal lobe and the right cerebellar hemisphere and the vermis. V-P Shunt was performed and left parietal craniotomy was done for removal of tumor. The patient received radiation therapy and chemotherapy for brain tumor with a good result Histogenesis and therapy of the microgliomatosis are briefly discussed.
Brain Neoplasms ; Brain* ; Craniotomy ; Drug Therapy ; Humans ; Parietal Lobe ; Rabeprazole

In the treatment of the intracranial gliomas surgical intervention is recommended as the standard procedure which should be performed in all cases when the tumor is accessible. While surgery will not bring about a cure and clearly, radiation therapy and chemotherapy have made a significant impact of long-term survival in the treatment of the malignant gliomas, nevertheless surgery still remains the single most effective method for achieving a rapid reduction of tumor burden reducing increased intracranial pressure and provides a tissue diagnosis. Following surgery, the other antitumor programs have the best chance of achieving a significant increment of tumor cell kill, therefore, surgery has a distinct role to play in the multidisciplinable approach to the treatment of these highly aggressive malignant tumors. It is very unlikely that future advances will obviate the necessity for conventional surgery in the treatment of benign gliomas. The surgical management of gliomas with major emphasis on malignant ones is presented including the pathophysiology, radiological diagnosis, aim of surgery, surgical procedure and some different possibility of surgical treatment. Prospective future development of surgical treatment of brain tumor is also considered.
Brain Neoplasms ; Diagnosis ; Drug Therapy ; Glioma* ; Intracranial Pressure ; Tumor Burden

Brain Neoplasms ; drug therapy ; Cardiovascular Diseases ; drug therapy ; Eye Diseases ; drug therapy ; Gastrointestinal Neoplasms ; drug therapy ; Head and Neck Neoplasms ; drug therapy ; Humans ; Lung Neoplasms ; drug therapy ; Neoplasms ; drug therapy ; Photochemotherapy ; Precancerous Conditions ; drug therapy ; Skin Diseases ; drug therapy ; Skin Neoplasms ; drug therapy ; Tooth Diseases ; drug therapy ; Urologic Neoplasms ; drug therapy

OBJECTIVETo study the change in ultrastructure of C6 glioma cells after photodynamic therapy (PDT), to compare morphological differences in necrosis and apoptosis before and after PDT treatment, and to evaluate the effect of photodynamic therapy on the blood brain tumor barrier (BTB) of C6 glioma.

METHODSThe model was produced by transplanting C6 glioma cells cultured in vitro using Peterson method into the caudate nuclei of Wister rats. The experiment group received PDT for two weeks after the operation. The sub-cellular structure, blood-brain-barrier (BBB) and BTB in both groups were observed under electron microscope.

RESULTSApoptosis in different phases and necrosis could be observed in some C6 glioma cells. Swelling occurred on the ultrastructure of cellular organs such as mitochondria and endoplasmic reticulum in most of the cells. Damage to the BTB, reduction of the number of cellular organs in endothelial cells of the capillary blood vessels, stretch of the tight junction, and enlargement of the gaps between endothelial cells were also seen in the experiment group. Meanwhile, limited impact on the normal sub-cellular structures and BBB was observed.

CONCLUSIONPDT could induce apoptosis and necrosis of C6 glioma cells due to the damage to the ultrastructure of mitochondria and endoplasmic reticulum. The weakened function of C6 glioma BTB initiated by PDT makes it possible to perform a combined therapy of PDT and chemotherapy for glioma.

Animals ; Blood-Brain Barrier ; Brain Neoplasms ; drug therapy ; ultrastructure ; Cell Line, Tumor ; Glioma ; drug therapy ; ultrastructure ; Photochemotherapy ; Rats

Despite advances in neurosurgery, radiation, and chemotherapy, the prognosis of patients with malignant brain tumors still remains grim. Considerable efforts have been made to develop new therapeutic strategies for malignant brain tumors. One of the promising new therapies for brain tumors is an intervention at molecular level, and several molecular approaches have been shown to have in vitro and in vivo activities. These include the use of retroviral vectors, herpes simplex viruses, adenoviral vectors in gene transfer, and antisense vectors and oligonucleotides. Preclinical studies of retroviral vector have already been extended to clinical trials, clearly demonstrating the clinical potential of these molecular therapies. Here, I discuss the current status of molecular therapy for brain tumors together with future directions for its development.
Brain Neoplasms* ; Brain* ; Drug Therapy ; Humans ; Neurosurgery ; Oligonucleotides ; Oligonucleotides, Antisense* ; Prognosis ; Simplexvirus ; Zidovudine

Brain SPECT with Tc-99m-Glucoheptonate(GH) and Tc-99m-HMPAO were performed in 41 patients with brain tumors to determine the difference of uptake ratio in various histological type of tumors. SPECT studies were carried out with a rotating gamma camera in 60 minutes after intravenous injection of 15mCi of Tc-99m-GH and Tc-99m-HMPAO respectively. We counted tumor/skull(T/S) ratio on Tc-99m-GH SPECT(30 cases) and tumor/normal(T/N) ratio on Tc-99m-HMPAO SPECT(33 cases) by the use of ROI(Region of Interest) analysis. In our present study, we obtained positive uptake scans in all cases of brain tumors performed Tc-99m-GH SPECT and there was statistically significant correlation among certain type of tumor and uptake ratio. On Tc-99m-HMPAO SPECT, most of brain tumors showed decreased uptake, even in the tumors showing increased vascularity on angiographys and no definite correlation was found between tumor type and uptake ratio. Conclusively, brain SPECT with Tc-99m-GH is considered to be simple but very sensitive method in detecting brain tumors and has some value in preoperative differentiation of tumor types. Tc99m-HMPAO SPECT could be used as a tool of predicting the response to chemotherapy or radiation therapy if it was performed preoperatively and during the postoperative course.
Brain Neoplasms* ; Brain* ; Drug Therapy ; Gamma Cameras ; Humans ; Injections, Intravenous ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Brain Neoplasms* ; Brain* ; Drug Therapy ; Medulloblastoma ; Neoplasm Metastasis* ; Neuroectodermal Tumors, Primitive

Brain tumor is the second most common tumor in childhood. The overall survival (OS) has improved significantly during the past 30 years due to developments in surgical technique, radiotherapy, chemotherapy, and high-dose chemotherapy and autologous peripheral stem cell rescue. At present, the 5 year OS of pediatric brain tumor is about 75% which, however, is still lower than that of other malignancies in childhood. Various clinical studies using radiotherapy combined with chemotherapy, multidrug chemotherapy, and monoclonal antibody have been conducted in order to cure patients with brain tumor. The Korean Society of Pediatric Neuro-Oncology is trying to develop standard therapy for the various types of pediatric brain tumor. Of special note, the standard treatment for pediatric glioma has not yet been established. Glioma is the most common histologic type of brain tumor in children. They are classified into 3 groups based on the WHO grade and location of tumor; low-grade glioma (LGG), high-grade glioma (HGG), and brainstem glioma (BSG). The prognosis of LGG is usually good if a complete surgical resection is feasible. Incomplete resected or progressive LGG are troublesome disease for pediatric oncologists. The survival rate of HGG and BSG is very low in spite of combined treatments with surgery, radiation, and chemotherapy. The aim of this review is to provide an overview of treatments for pediatric gliomas.
Brain Neoplasms ; Brain Stem ; Child ; Drug Therapy ; Glioma ; Humans ; Prognosis ; Radiotherapy ; Stem Cells ; Survival Rate