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Gliomatosis
cerebri: a review of 22 cases
Vates GE, Chang S, Lamborn KR, Prados M, Berger MS
Department of Neurological Surgery, University of California, San
Francisco, San Francisco, California, USA
Objective. Gliomatosis cerebri is an enigmatic diffuse brain neoplasm
whose prognosis is grim.
We reviewed data for patients with gliomatosis who were treated at the
University of California, San Francisco, during a 10-year period.
Our focus was on presentation, radiological and pathological features, and
outcomes.
Methods. We reviewed hospital and clinic records and magnetic
resonance imaging scans for 22 patients with gliomatosis.
The diagnosis was based on magnetic resonance imaging findings and tissue
confirmation for all patients.
Seven patients also underwent magnetic resonance spectroscopy.
Eleven patients were male (50%), and the median age at presentation was 49 years
(range, 7-79 yr).
Results. Kaplan-Meier analysis demonstrated median lengths of
survival as follows: no treatment, 1 month (n = 4); radiotherapy alone, 28
months (95% confidence interval, 5-51 mo; n = 13); radiotherapy followed by
chemotherapy, two patients, alive at 28 and 104 months; radiotherapy and
chemotherapy simultaneously, three patients, one alive at 18 months and the
others dead at 7 and 9 months.
There was no significant difference between radiotherapy alone and radiotherapy
combined with chemotherapy (P = 0.69).
Karnofsky Performance Scale scores of >/=70 and grade were both significantly
related to length of survival in univariate analyses (P < 0.05); these
correlations were confirmed in the multivariate analysis, although the small
numbers of patients and deaths precluded reliable interpretation.
Conclusion. Although the small number of patients in our study and
its retrospective nature preclude definitive conclusions regarding the utility
of treatment, our findings suggest that biopsies are useful not only for
diagnosis but also for prediction of the length of survival.
PMID: 12925240 [PubMed - in process]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12925240&dopt=Abstract
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