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Glioblastoma multiforme

Glioblastoma multiforme, (GBM) also known as grade 4 astrocytoma is the most common and aggressive type of primary brain tumor, accounting for 52 percent of all primary brain tumors cases. more...

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Treatment can involve chemotherapy, radiotherapy and surgery. The 5 year survival rate of the disease has remained unchanged over the past 30 years, and stands at less than three percent. Even with complete resection of the tumor, combined with the best available treatment, the survival rate for GBM remains very low. Chromosomal aberrations like PTEN mutation, MDM2 mutation, and p53 mutation are commonly seen in these tumors. Growth factor aberrant signaling associated with EGFR, and PDGF are also seen. Tumors of this type may also infiltrate across the corpus callosum, producing a butterfly glioma.

Glioblastoma multiformes are characterized by the presence of small areas of necrotizing tissue that is surrounded by highly anaplastic cells. This characteristic differentiates the tumor from Grade 3 astrocytomas, which do not have necrotic tissue regions. Although glioblastoma multiforme can be formed from lower grade astrocytomas, post-mortem autopsies have revealed that most glioblastoma multiforme are not caused by previous lesions in the brain. Metastasis of GBM beyond the Central Nervous System is extremely rare.

A variant of glioblastoma multiforme is known as gliomatosis cerebri. Instead of a solid tumor, the cancerous cells are more scattered and diffuse. This variant preserves the architecture of the brain, but causes the affected portion of the brain to swell. It is extremely difficult to diagnose.

Symptoms

Although common symptoms of the disease can include seizure, headache, and hemiparesis, the single most prevalent symptom is a progressive memory, personality, or neurological deficit. The kind of symptoms produced highly depends on the location of the tumor, more so than on its pathological properties. The tumor can start producing symptoms quickly, but occasionally is asymptomatic until it reaches an enormous size. Unlike oligodendrogliomas, glioblastoma multiformes can form in either the gray matter or white matter of the brain. The symptoms can be relieved, on a primary approach, by the administration of chorticotherapy. These drugs act by rearranging the blood-brain barrier and thus reducing brain oedema. Apart from this, not many different drugs have any kind of importance on this situation. Anti-convulsants, analgesics and stomach protection drugs are usually prescribed.

A Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) scan is necessary to characterize the anatomy of this tumor (size, location, heter/homogeneity). However, final diagnosis of this tumor, like most tumors, relies on histopathologic examination (biopsy examination) after biopsy or surgery.

Treatment

Treatment of primary brain tumors and brain metastases consists of both supportive and definitive therapies.

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Asthma and allergies may reduce risk
From USA Today (Society for the Advancement of Education), 10/1/05

Having asthma, hay fever, or another allergic condition may reduce the risk of developing one fatal form of brain cancer, suggests a study from Ohio State University, Columbus. New evidence for this relationship is found in the normal variation of two genes.

"Variations in certain genes may make a person more prone to develop asthma or allergies and those same variations may protect adults against the most common kind of brain cancer," says Judith Schwartzbaum, associate professor of public health.

Glioblastoma multiforme (GBM) affects three out of 100,000 people, a rate that quadruples among those who are 65 and older. The average five-year survival rate from the time of diagnosis is 3.3%.

The current study supports several years' worth of research by other scientists who have suggested an inverse relationship between asthma, allergies, and GBM. Those studies, however, were based only on information that participants gave about their history of asthma and allergies, not on data from DNA testing.

"We needed an objective way to measure the accuracy of allergy self reports, one that isn't affected by the presence of a brain tumor," Schwartzbaum notes. "Looking at genetic variation is one way to do this."

That genetic variant is called a polymorphism. While a mutation has a rare and abnormal DNA pattern, a polymorphism consists of common patterns, each considered normal. Polymorphisms can offer protection against certain diseases or render a person more vulnerable to particular conditions. For example, researchers suspect that several polymorphic forms of key genes may increase susceptibility to Alzheimer's disease.

The researchers looked for polymorphisms on two genes associated with asthma and allergies, IL-4RA and IL-13. "People who have polymorphisms in the two genes that we examined may be susceptible to allergic conditions and may also have a lower risk of GBM," Schwartzbaum concludes.

COPYRIGHT 2005 Society for the Advancement of Education
COPYRIGHT 2005 Gale Group

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