Gliomas — including Glioblastoma multiforme (GBM), anapastic astrocytoma and oligodendroglioma — are best treated with a team approach. This typically includes minimally invasive surgery, targeted medical therapies & radiotherapy.
The initial optimal treatment for most gliomas is maximal surgical removal. For patients with higher grade gliomas, surgery is followed by radiation therapy and chemotherapy. Fortunately, most gliomas can be surgically removed through one of several keyhole routes depending upon tumor location and size.
At the Pacific Brain Tumor Center, we incorporate leading-edge technology such as MRI fiber tractography, functional MRI , surgical navigation and awake craniotomy protocols, with proven surgical experience, to make glioma surgery safer, less invasive and more effective. We have a large experience in the comprehensive personalized care of all types of gliomas including low grade astrocytomas, oligodendrogliomas, anaplastic astrocytomas and glioblastomas.
Our neurosurgeons Dr. Achal Singh Achrol and Dr. Daniel Kelly work closely with our neuro-oncologists, Dr. Santosh Kesari and Dr. Jose Carrillo, as well as our radiation oncologists and neuropathologists to design the optimal treatment plan that incorporates the latest in radiotherapy techniques and tumor biomarker studies. By using comprehensive tumor histological subtyping and genomic sequencing, we are able to provide a personalized therapeutic approach for each patient. Our team can also facilitate participation in clinical trials using novel medical therapies for patients with gliomas.
Keyhole Brain Tumor
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Gliomas are the most common type of primary brain tumor. They can occur at any age and in any part of the brain or spinal cord where glial cells (the support cells of the nervous system) are located. There are 3 major types of gliomas: astrocytomas, ependymomas and oligodendrogliomas. Astrocytomas are defined by their histological grade from low grade to high grade. The most common type of glioma is the high grade glioblastoma multiforme (GBM) which is rapidly growing and generally carries a poorer prognosis. Lower grade astrocytomas (grades 1 and 2 and pilocytic astrocytomas) are generally slow growing and carry a better prognosis.
Symptoms from a glioma are variable and depend on tumor location and size; common complaints include headache, seizures, confusion, weakness, numbness, imbalance or in-coordination, memory impairment and personality changes.
The diagnosis of a glioma is typically made by a brain MRI with and without contrast (gadolinium), but most gliomas can also be seen on a CT scan. Magnetic resonance spectroscopy may also be used to better define the nature of the tumor.
Because gliomas are infiltrative into the brain and blend into the adjacent normal brain, they typically cannot be removed completely. Consequently treatment of gliomas may involve surgical debulking, typically through a keyhole craniotomy approach followed by radiotherapy and chemotherapy. In many instances, all 3 of these treatments are needed. For most patients with a glioblastoma multiforme, surgical debulking, whole brain radiotherapy and temazolamide chemotherapy is considered standard treatment. Although the average survival of a patient with a glioblastoma is typically under 2 years, new treatments are continually being developed. Additionally, genomic sequencing of gliomas offers many new treatment options for our patients allowing for personalized treatments and clinical trial options based on the specific tumor markers on each patient.
- Learn about our multidisciplinary team
- Learn about our Integrated Neuro-Oncology Research Program
- Learn about the Kesari Translational Neuro-Oncology Lab