Practical considerations in the management of adults with malignant astrocytomas

S. A. Grossman, M. Zeltzman

Research output: Contribution to journalArticle

Abstract

BACKGROUND- Malignant astrocytomas in adults are aggressive tumors that are increasing in incidence especially in the elderly. Although these appear as a localized process, intensive local therapies have failed to provide cures as a result of the invasiveness of these malignancies. Age, histology, performance status, and extent of resection are powerful prognostic factors. Unique aspects of these tumors and the brain in which they reside pose practical management dilemmas to health care providers. REVIEW SUMMARY- The complex issues regarding surgery, radiation therapy, chemotherapy, the role of research studies, and special considerations in the use of glucocorticoids, anticonvulsants, and anticoagulants in this patient population are reviewed. In addition, practical aspects of the management of patients dying of malignant astrocytomas and the importance of recognizing the unique stresses of this illness on patients and family members are discussed. Novel antineoplastic approaches, less toxic agents to control peritumoral edema, and improved supportive care are key to improving both the quality and quantity of life for patients with this devastating disease. CONCLUSION- Familiarity with the practical aspects of managing patients with malignant astrocytomas enables neurologists to provide optimal care to their patients and address the concerns of neurosurgeons, radiation therapists, oncologists, nurses, social workers, hospice personnel, and others who are increasingly involved in the care of these patients.

Original languageEnglish (US)
Pages (from-to)130-138
Number of pages9
JournalNeurologist
Volume2
Issue number2
StatePublished - Dec 1 1996

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Keywords

  • Anticonvulsants
  • Chemotherapy
  • Glioblastoma multiforme
  • Glucocorticoids
  • Malignant astrocytoma
  • Radiation therapy
  • Supportive care
  • Surgery

ASJC Scopus subject areas

  • Clinical Neurology

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