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Palliative Benefits of the Multimodality Approach in the Re-treatment of Recurrent Malignant Glioma: Two Case Reports.

Tr A, Mg J, S N - Indian J Palliat Care (2009)

Bottom Line: Both underwent resurgery and received postoperative reirradiation of 5040 cGy in 28 fractions and concurrent Temozolomide 75 mg/m(2) body surface area (BSA) daily, and one patient received additional adjuvant Temozolomide 250 mg (150 mg/m(2) BSA).Both patients tolerated the treatment well with 16 and 14 months follow-up from the time of recurrence.They were symptom-free, with normal physical function and good mental state, and resumed their respective jobs.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, M.S. Ramaiah Medical Teaching Hospital, Bangalore - 560 054, India.

ABSTRACT
Two young male patients treated seven and four years back, for malignant glioma, returned with recurrence at the same site, with a World Health Organization (WHO) Performance Score of four and two. Both underwent resurgery and received postoperative reirradiation of 5040 cGy in 28 fractions and concurrent Temozolomide 75 mg/m(2) body surface area (BSA) daily, and one patient received additional adjuvant Temozolomide 250 mg (150 mg/m(2) BSA). Both patients tolerated the treatment well with 16 and 14 months follow-up from the time of recurrence. They were symptom-free, with normal physical function and good mental state, and resumed their respective jobs.

No MeSH data available.


Related in: MedlinePlus

MRI of case one in the axial (T1 & T2 weighted) and sagittal views, demonstrating a mass lesion with extensive edema in the right parieto-occipital region with midline shift
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Figure 0001: MRI of case one in the axial (T1 & T2 weighted) and sagittal views, demonstrating a mass lesion with extensive edema in the right parieto-occipital region with midline shift

Mentions: Mr. N aged 35 years came to our Outpatient Department (OPD) on 4 July, 2008 with a history of (h/o) convulsions, left-sided weakness, swaying gait due to dragging of left foot, associated with headache since three months. He had no h/o vomiting. His WHO Performance score was four. He gave a h/o having undergone surgery seven years prior for convulsions and had received postoperative Radiotherapy and Chemotherapy for AA to the (R) parieto-occipital region. On examination (O/E) for the power on the left (L) side was grade 4/5, gait showed dragging of (L) foot and swaying to the left side. Computed tomography (CT) of the brain [Figure 1] showed SOL (space occupying lesion) in the right (R) parieto-occipital region. He underwent decompression of the lesion and histopathology showed Anaplastic Oligodendroglioma Grade III. The patient received postoperative radiation therapy (RT) of 3960 cGy and boost of 1080 cGy, 180 cGy/fraction, and concurrent Temozolomide 75 mg/m2 BSA given daily. After one week from the start of RT, the patient developed convulsions for which he was started on anticonvulsants. At one month follow-up he had persistent left-sided weakness, gait disturbance, and headache. He developed blurring of vision. His power was status quo and fundoscopy was normal. It was planned to start on adjuvant Temozolomide, but due to non-affordability and non-compliance he was lost to follow-up. On telephonic enquiry dated 31 July, 2009, the patient was fine, on Tab Gardenal 60 mg twice daily and he was seizure-free from seizure. He came for follow-up on 13 August, 2009. He is fine with no seizures, good mental status, normal gait, and no neurological deficits, so far, with a follow-up of 16 months from the time of recurrence.


Palliative Benefits of the Multimodality Approach in the Re-treatment of Recurrent Malignant Glioma: Two Case Reports.

Tr A, Mg J, S N - Indian J Palliat Care (2009)

MRI of case one in the axial (T1 & T2 weighted) and sagittal views, demonstrating a mass lesion with extensive edema in the right parieto-occipital region with midline shift
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2902119&req=5

Figure 0001: MRI of case one in the axial (T1 & T2 weighted) and sagittal views, demonstrating a mass lesion with extensive edema in the right parieto-occipital region with midline shift
Mentions: Mr. N aged 35 years came to our Outpatient Department (OPD) on 4 July, 2008 with a history of (h/o) convulsions, left-sided weakness, swaying gait due to dragging of left foot, associated with headache since three months. He had no h/o vomiting. His WHO Performance score was four. He gave a h/o having undergone surgery seven years prior for convulsions and had received postoperative Radiotherapy and Chemotherapy for AA to the (R) parieto-occipital region. On examination (O/E) for the power on the left (L) side was grade 4/5, gait showed dragging of (L) foot and swaying to the left side. Computed tomography (CT) of the brain [Figure 1] showed SOL (space occupying lesion) in the right (R) parieto-occipital region. He underwent decompression of the lesion and histopathology showed Anaplastic Oligodendroglioma Grade III. The patient received postoperative radiation therapy (RT) of 3960 cGy and boost of 1080 cGy, 180 cGy/fraction, and concurrent Temozolomide 75 mg/m2 BSA given daily. After one week from the start of RT, the patient developed convulsions for which he was started on anticonvulsants. At one month follow-up he had persistent left-sided weakness, gait disturbance, and headache. He developed blurring of vision. His power was status quo and fundoscopy was normal. It was planned to start on adjuvant Temozolomide, but due to non-affordability and non-compliance he was lost to follow-up. On telephonic enquiry dated 31 July, 2009, the patient was fine, on Tab Gardenal 60 mg twice daily and he was seizure-free from seizure. He came for follow-up on 13 August, 2009. He is fine with no seizures, good mental status, normal gait, and no neurological deficits, so far, with a follow-up of 16 months from the time of recurrence.

Bottom Line: Both underwent resurgery and received postoperative reirradiation of 5040 cGy in 28 fractions and concurrent Temozolomide 75 mg/m(2) body surface area (BSA) daily, and one patient received additional adjuvant Temozolomide 250 mg (150 mg/m(2) BSA).Both patients tolerated the treatment well with 16 and 14 months follow-up from the time of recurrence.They were symptom-free, with normal physical function and good mental state, and resumed their respective jobs.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, M.S. Ramaiah Medical Teaching Hospital, Bangalore - 560 054, India.

ABSTRACT
Two young male patients treated seven and four years back, for malignant glioma, returned with recurrence at the same site, with a World Health Organization (WHO) Performance Score of four and two. Both underwent resurgery and received postoperative reirradiation of 5040 cGy in 28 fractions and concurrent Temozolomide 75 mg/m(2) body surface area (BSA) daily, and one patient received additional adjuvant Temozolomide 250 mg (150 mg/m(2) BSA). Both patients tolerated the treatment well with 16 and 14 months follow-up from the time of recurrence. They were symptom-free, with normal physical function and good mental state, and resumed their respective jobs.

No MeSH data available.


Related in: MedlinePlus