How long do people with glioma grade 3 to 4 end up living?

How long do people with glioma grade 3 to 4 end up living? Treatment of recurrent glioblastoma multiforme.

Glioma grade 4 is also called glioblastoma (GBM), which is a highly malignant glioma. Similar to other tumors, the cause of death of malignant glial cell tumors is sometimes not very clear. Some patients died of space-occupying effect and the corresponding brain herniation, and some patients died of no significant space-occupying effect. Since malignant glial cell tumors rarely have metastases outside the nervous system, the typical progressive neurological decline and final death are likely to be caused by brain damage of unknown mechanism. Although tumors have a faster lethality for patients, it is still not uncommon for patients to survive for a long time.

The survival period of patients with GBM and glioma after surgical resection alone is 16 weeks. If traditional radiotherapy is applied again, the survival period can be extended to about 39 weeks. If additional brachytherapy can further extend its survival. For malignant glioma, histological type, age, KPS score and radiotherapy are the most important aspects that affect its survival. The survival period for radical treatment of GBM is about 1 year. The survival time of GBM treated with surgery alone is approximately 16 weeks.

A special review of patients undergoing radiotherapy, among the factors affecting the prognosis, age and KPS score are the most important factors affecting the prognosis of GBM. Patients who are older than 50 years old and have a KPS score less than 70 (patients cannot take care of themselves in daily life and do need other people’s care) only have an average survival period of 4-9 months, while patients who are younger than 50 years old and have a significantly changed KPS score The survival period is about 11 months, and the survival period of those who are rarely affected by the KPS score can reach 18 months.

Since patients older than 70 years of age were excluded and analyzed, the actual survival time of the study may be higher than the cited literature. For adults, there is an inverse relationship between age at diagnosis and survival. Many long-term survival patients (more than five years) have been reported in the literature. It is unclear whether these patients are unique subgroups of GBM or misdiagnosis. They account for about 5% of patients diagnosed with malignant glioma.

Treatment of recurrent glioblastoma multiforme

The treatment of relapsed GBM is more limited. Many patients have received whole brain radiotherapy and chemotherapy before recurrence. Feasible treatment methods include reoperation, infusion of chemotherapy drugs, stereotactic X-knife therapy or brachytherapy. Without further treatment, the average survival time of patients with tumor recurrence is 16 weeks.

Re-operation can prolong the survival period by 14-36 weeks. Of course, the prolongation of survival period is also affected by preoperative KS and preoperative chemotherapy. Inserting a BCNU chemotherapy pump can extend the survival period to 30 weeks. Many patients with recurrent gliomas can be treated with multiple brachytherapy seeds. The application of brachytherapy with lower activity after the second operation can extend the average survival time to 65 weeks.

In the treatment of recurrent GBM, intraoperative application of low activity (with a half-life of about 60 days) implanted in the 5mm range around the tumor for brachytherapy, the effect is obvious. The prolongation of the patient’s survival period is affected by the accuracy and technology of seed placement. If the surgery uses frameless stereotactic technology and cortical atlas technology, safer and more extensive surgical resection and the application of more complex radiation dosimetry can be performed.

(source:internet, reference only)

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