Primary brain tumors: multidisciplinary treatment approach. A retrospective case study

Abstract

Introduction: Brain Cancer is one of the most agressive forms of cancer and has without a doubt the most dramatic presentation leading to losing one’s self awareness. Primitive brain tumors are a heterogenous group of tumors arising from cells originating in the brain. They are divided by the World Health Organisation (WHO) in high grade tumors and low grade tumors by how fast they are likely to grow. Methods and Materials: We conducted a retrospective study of 209 patients from the Oncology Departement of „Saint Andrew” Conty Hospital suffering from primary brain tumors from 2006 to 2015. We analyzed data pulled from the archives using Microsoft excel and IBM SPSS. Results: As a result of the expansive nature of brain tumors, 63% of patients presented with high ICP, motor disfunctions 43%, headaches 24%. Neuroimagistic examination was performed and identified 95% of the masses located in the supratentorial level. After histopatological examination 79% of tumors were identified as high grade and only 21% low grade; the most common tumor type found was astrocitoma (78%) which was also Associated with the highest rate of recurrence of 90%, of which 15% recured with a higher grade than before. Treatment depended on tumor type and size: 34% of patients underwent adjuvant ERT(Co60) and 56 % of them received concomitent ERT(Co60) with Temozolamide. 10% received palliative ERT. 21% developed hepatotoxicity after CMT and 33% devloped gastrointestinal toxicity. 96% of patients developed asthenia as ERT side effect followed by 74% with encephalopathy. Maximum progresion free survival rate was 36 months for 12 patients who underwent total debulking.Conclusions: Astrocitomas have the worst prognostic and the highest probability to recure even after optimal treatment. Chemotherapy with Temozlamide is a superior adjuvant therapy, with less side effects encountered compared to Co60 ERT which was Associated with quality of life altering effects.