Gliomatosis cerebri medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]
Overview
The predominant therapy for gliomatosis cerebri is surgical resection. Adjunctive chemotherapy and radiation may be required. Supportive therapy for gliomatosis cerebri includes anticonvulsants and corticosteroids.
Medical Therapy
The predominant therapy for gliomatosis cerebri is surgical resection. Adjunctive chemotherapy and radiation may be required. Supportive therapy for gliomatosis cerebri includes anticonvulsants and corticosteroids.
Radiotherapy
- Post-operative radiotherapy is recommended among all patients who develop gliomatosis cerebri.
- Radiotherapy may not cure the cancer, but can control the tumor and delay recurrence.
- Targeted three-dimensional conformal radiotherapy is preferred to whole brain radiotherapy.
- The median dose of radiation is 55.4 Gy (range, 45–61.2 Gy).
Chemotherapy
- Chemotherapy is indicated as adjuvant therapy for gliomatosis cerebri.
- Temozolomide (Temodar) is the preferred drug for the treatment of gliomatosis cerebri.
- Other chemotherapeutic drugs that may be used for the treatment of gliomatosis cerebri include:
Supportive treatment
- Supportive therapy for gliomatosis cerebri includes anticonvulsants and corticosteroids, which focuses on relieving symptoms and improving the patient’s neurologic function.
- Anticonvulsants are administered to the patients who have a seizure. Phenytoin given concurrently with radiation may have serious skin reactions such as erythema multiforme and Stevens-Johnson syndrome.
- Corticosteroids, usually dexamethasone given 4-10 mg every 4-6 h, can reduce peritumoral edema, diminish mass effect, and lower intracranial pressure with a decrease in headache or drowsiness.