Preirradiation Or Neoadjuvant Chemotherapy

Neoadjuvant chemotherapy refers to treatment given at diagnosis before other modalities such as radiation. It has several potential advantages. First, neoadjuvant chemotherapy allows early treatment of the infiltrating tumor cells that may be at or beyond the border of the radiation field. Second, neoadjuvant chemotherapy allows true assessment of the efficacy of the chemotherapy. Such information is important at the time of tumor progression in deciding whether treatment with the same regimen...

Fatigue

The neurologic disorder in which fatigue has been best evaluated is multiple sclerosis in which at least 78 of these patients suffer from fatigue and is often the most disabling symptom of this disease (55). Similarly, in a study of over 1300 cancer patients, 58 of patients described problems with fatigue, yet less than 52 of those ever reported symptoms to their caregivers, and only 14 had received some type of treatment (56). Perhaps the greatest obstacle to recognizing fatigue is in terms of...

Roberta P Glick Terry Lichtor Henry Lin and Edward P Cohen

The prognosis for patients with malignant glioma is poor. Conventional treatments such as surgery, radiation therapy, and chemotherapy have done little to affect long-term survival, and new methods of treatment are urgently needed. In this report, approaches involving cytokine gene therapy in treatment of malignant brain tumors are reviewed and contrasted with a strategy developed in this laboratory involving the use of allogeneic cells which have been genetically modified to secrete cytokines....

Clinical Presentation

Symptoms or signs of brain tumors are produced by the tumor mass, the adjacent edema, or the infiltration and destruction of normal tissue. However, these symptoms and signs and are best appreciated by considering the tumor location and growth rate. For example, rapidly growing tumors located in eloquent cortex or along the ventricular system may manifest after only a small amount of growth. Those in less eloquent areas of the brain may manifest only after substantial growth. Moreover, no...