ABSTRACT
Os meningiomas são os tumores cerebrais mesodermais,ocorrendo em 13 por cento a 19 por cento de todos os tumores cerebrais.Cerca de 40 por cento deles ocorrem na base do crânio,na região selar, e 10 por cento nas regiões parasselares, incluindo a região da asa do esfenóide,bulbo olfatório,tubérculo e diafragma selares. É relatado o caso de paciente com meningioma angiomatoso selar,submetido previamente à cirurgia transesfenoidal e, posteriormente, tratado por radiocirurgia estereotáxica. A evolução foi satisfatória, com remissão completa das crises de cefaléia e da ptose preexistente.
Subject(s)
Humans , Male , Adult , Meningioma/surgery , Meningioma/diagnosis , Meningioma/therapy , Radiosurgery , Stereotaxic TechniquesABSTRACT
BACKGROUND: Anaplastic astrocytomas (AA) and glioblastomas (GB) are the most common malignant gliomas, and despite newly developed drugs and combined treatments, they still have an adverse prognosis. Paclitaxel is a cytotoxic agent with radiosensitizing properties and exerts objective growth inhibition in glioma tumor cells. PATIENTS AND METHODS: From 1998 to 2002, 61 microneurosurgically treated patients were randomized to group I (18 GB, 14 AA) which received radiotherapy and weekly paclitaxel at dose of 100 mg/m(2), and group II (21 GB, 8 AA) which received only radiotherapy as a complementary treatment. RESULTS: Median overall survival was 27.96 months in group I and 23.06 months in group II with no statistical difference. The 12-month survival was 81% in group I and 76% in group II. Kaplan-Meier curves of both groups did not demonstrate any difference. Analysis of each histological subgroup (AA or GB) also showed no statistical difference in the survival curves. All 427 cycles were well tolerated with no treatment-associated deaths. CONCLUSIONS: Chemoradiotherapy with weekly paclitaxel is safe and tolerable although there was no increase in the overall survival and 12-month survival of malignant glioma patients. Further investigations modulating the paclitaxel entrance and delivery into the brain should be encouraged.
