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Glioblastoma is a tumor of the brain and spinal cord. Gliomas originate from the glial cells that make up the stroma of the nervous tissue. Gliomas account for approximately 70 percent of all intracranial tumors and are the leading cause of death in this group of brain tumors. Read about the symptoms of glioblastoma and how these types of brain tumors are treated.

Glioblastoma, or rather gliomas, is a group of variousbrain and spinal tumors , which results from differences in the structure of individual glial cells that perform supporting, nutritional and repair functions for neurons.

The more demarcated from adjacent tissues, and thus less diffuse (infiltrating), the easier the surgical removal ( resection ) is. The treatment also includes chemotherapy, radiotherapy (brachytherapy and teleradiotherapy, including gamma knife therapy) andexperimentaltherapies - incl. gene therapies, immunotherapy or virotherapy. What are the symptoms of glioblastoma? How are such brain tumors treated?

Glioma: symptoms

Clinical symptoms of gliomas depend primarily on where the tumor appeared:

SymptomsGeneral(Symptoms of increased intracranial pressure:

  • headaches,
  • nausea and vomiting most severe in the morning,
  • psychoorganic syndrome - weakened mental performance,
  • memory impairment,
  • generalized seizures,
  • brain swelling.

Symptomsfocal , specific to the tumor location:

  • paresis,
  • sensory disturbance,
  • speech disorder,
  • visual disturbance,
  • hearing impairment,
  • cerebellar symptoms - e.g. balance disorders,
  • cranial nerve damage,
  • focal epileptic seizures.

Glioma: types

A glioblastoma can grow out of:

  • cells of the astrocytic line (glioblastoma multiforme, anaplastic, filamentous and hairy astrocytoma);
  • oligosendomous cells (oligodendroglioma) - about 10 percent of gliomas;
  • cells that line the ventricles of the brain (ependymoma) - about 7 percent of gliomas;
  • germ cells (medulloblastoma) - usually occurs in children, locating in the cerebellum, although it is sometimes recognizedalso in adults. It is characterized by rapid growth and is radiosensitive.

Glioblastoma multiforme

The most common and most dangerous glioblastoma is glioblastoma multiforme. It develops in the cerebral hemispheres, most often in the frontal and temporal lobes, which may appear as:

  • change of the patient's personality,
  • disturbed mental functions,
  • aphasia,
  • epileptic seizures.

It occurs in the elderly and is very malignant - without treatment, almost all patients die within three months. After using combined treatment, i.e. surgery and radiotherapy, it is possible to extend the life span up to a year. Only5 percentof patients achieve long-term survival.

astrocytomas, oligodendpers and ependymomas

Young adults develop astrocytomas: filamentous, which often turn into glioblastoma multiforme, and capillary, which are benign tumors, as well as infiltrating hemispheres of oligodendrogliomas and ependymomas located in the IV ventricle.

The basis for the treatment of each of them is surgery with the fullest possible resection of the tumor, often supplemented with radiotherapy. The prognosis depends on the radical nature of the operation, but 5-year survival is achieved, on average, in over65 percent of patients .

Childhood gliomas

Childhood gliomas are most often medulloblastomas located in the cerebellum, subtentorial ependymomas and hair cell astrocytomas. These tumors are treated surgically, in young children they are supplemented with chemotherapy, and in the elderly - with radiotherapy. Five years after the end of therapy, approx.60% of children .

New therapy as a chance for children with gliomas?

At the genetic level, gliomas are very diverse, although macroscopically and under the microscope they are very similar to each other and treated in a similar way. According to specialists from the Institute of Cancer Research in London (ICR), who published the results of their research in 2022, the times when cancer treatment is selected based on the appearance of its cells under a microscope should be a thing of the past.

To be treated according togenetic subtype . According to the researchers, some genetic subtypes that have been thrown into the same bag with others, may turn out to be curable, provided that the right drug is used. Drugs can be used, in appropriate combinations, and in this group of patients, if they are found to have gene mutations such as: BRAF, PDGFRA, KIT, MYCN, EGFR, CDK6.

Glioma: malignancy and prognosis

According to the WHO classification, we divide gliomas into two groups taking into account the malignancy:

  • olow-gradecomposed of highly mature, differentiated, low-proliferating cells with good prognosis;
  • ohigh-grade- cells are undifferentiated or anaplastic, grow rapidly, can infiltrate adjacent tissues, there are numerous lesions of necrosis, excessive proliferation of blood vessels - the prognosis in the latter case is of course worse.

In the four-level WHO scale, the prognosis is worse, the higher the stage of advancement:

I- this is e.g. hair cell astrocytoma or mucopapillary ependymoma,II- this is e.g. fibrocystic astrocytoma, oligoastoma, ependymoma,III- this is e.g. anaplastic astrocytoma,IV- this. e.g. glioblastoma multiforme (the most common glioblastoma in adults), medulloblastoma.

The prognosis for grade IV is worst, with average survivalapprox. 14 months , with surgery and subsequent radiotherapy and chemotherapy.

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Category:

Oncology