Journal of Cancer Therapy | 2021
Management of Malignants Gliomas: About 20 Cases Treated in the Medical Oncology Department of Fattouma Bourguiba University Hospital-Monastir
Abstract
Introduction: Malignant gliomas refer to grade III or IV brain tumors defined according to the World Health Organization \n(WHO) classification. They are a \nheterogeneous group of pathologies and represent a serious health problem by their frequency, severity and treatment difficulties. The prognosis \nof malignant gliomas remains poor despite all the medical advances. Materials and Methods: It is a retrospective study included 20 cases of \nmalignant glial tumors treated at the \nmedical oncology department, Fattouma Bourguiba hospital in Monastir \nbetween 2012 and 2016, according to the STUPP protocol. Results: These \nwere 12 men and 8 women with a median age of 43. Clinical signs were not very \nspecific, dominated by intracranial hypertension and deficit signs. Imagery referred to the diagnosis of malignant gliomas in \n1st intention. Surgery consisted of a macroscopically complete exeresis \nin (15%) cases, a partial exeresis in (50%), the rest of the patients had a \nstereotactic biopsy. Histology found GBM in 16 patients (80%), 2 cases of Grade \nIII anaplastic astrocytoma (10%), 1 case of anaplastic oligodendroglioma (5%), \nand 1 case of Grade III anaplastic eppendymoma (5%). Most of our patients \nreceived concurrent radio-chemotherapy and adjuvant TMZ chemotherapy was \nadministered in 15 patients, 7 of whom received the full 6 scheduled cures. A \nrelapse treatment was decided in only one of the 12 patients who relapsed. 6 \npatients are still alive. The median survival is 11.27 months. In our series, \noverall survival was related to histological type (p = 0.006) and neurological \nstatus assessed at the end of RT-CT (p = 0.001). While age, general condition \nscore, type of surgery, and post-therapeutic development did not show a statistically significant \nrelationship, although survival rates were consistent with the criteria assessed. Conclusion: Malignant gliomas are rare \ntumors, bad prognosis, aggravated in Tunisia by a diagnostic \ndelay. The creation of a multidisciplinary neuro-oncology group can help to \nimprove management.