Cerebral Glial Tumors: General Principles of Diagnostics and Treatment

  • Alexander Petrovich Trashkov St. Petersburg State Pediatric Medical University
  • Andrei Leont'evich Spirin St. Petersburg State Pediatric Medical University
  • Nikolai Vasilievich Tsygan Russian Medicomilitary Academy
  • Margarita Radievna Artyomenko St. Petersburg State Pediatric Medical University
  • Vareriya Antonovna Pechatnikova St. Petersburg State Pediatric Medical University
  • Nikolai Alexandrovich Verlov St. Petersburg State Pediatric Medical University

Abstract

Cerebral glial tumors continue to be a relevant issue of contemporary medicine in spite of considerable breakthroughs in oncology and neurosurgery. Cerebral gliomas constitute about 40-45 % of all glial tumors’ general structure; these tumors are mostly diagnosed at the age of 30-60 thus affecting the most able-bodied segment of population. Glial tumors usually arise out of astrocytal or oligodendrocytal cell population and are characteristic of high growth rate, invasiveness, early metastatic ability, high rate of recurrence and unfavorable prognosis. The present paper focuses at the contemporary clinical classification of gliomas based upon their location, histogenesis and activity of growth. Invasive growth with absence of distinct macroscopic border between the tumor and normal brain tissue is a characteristic peculiarity of glial brain tumors. This type of growth is peculiar for fast-growing highly malignant gliomas (anaplastic astrocytomas, glioblastomas). It is characteristic of unfavorable outcome. Anaplastic gliomas like a majority of malignant tumors are characteristic of intensive development of pathologic vascular network which boosts the rate of tumor growth as well as the intensity of metastases-forming also increasing the risk of cerebral hemorrhage into the tumor. Nodal type of growth with distinct border and moderate infiltration is less typical and may be found in case of conditionally benign gliomas with more favorable prognosis. The paper gives a detailed review of basic surgical, radiological and chemotherapeutical approaches towards treatment of gliomas. Closing the review the authors conclude that methods described in the paper do not exhaust all suggested improvements of glial tumors treatment and that elaboration of novel methods will bring neurooncologists closer to solving this actual problem.