Glial Tumors: Our Treatment Results In 145 Patients

Purpose: Glial tumors make up 40-50 % of brain tumors and they form a group of malignancies with variable prognosis with respect to their location and histopathological subgroups. In our study, 145 patients diagnosed to have glial tumors who presented to our department between 1990 and 1999 were evaluated retrospectively and factors affecting survival were analysed.
Material and Method: 111 patients with astrocytic tumors, 14 patients with oligodendroglial tumors, 7 patients with ependymal tumors and 13 patients with primitive neuroectodermal tumors were evaluated. Of these patients 77 were male and 68 were female (male.female ratio=l: 1). Peak incidence was at 31-40 years of age. Subtotal resection had been performed in 52 patients, 61 patients (42%) had undergone total resection and 4 patients had undergone lobectomy. Radiotheraphy (RT) was applied to the tumor bed in 33 patients. 91 patients received cranial RT and 9 patients received craniospinal RT. Mean follow-up time for the whole group was 26 months. Mean follow-up time was 31 months for patients with G 1-2 tumors, 21 months for patients with G 3 tumors and 16 months for those with g 4 tumors. Follow-up time was 26 months for patients who had undergone subtotal resection, 34 months for those who had undergone total resection and 10 months for whom lobectomy was performed.
Results: The best result was achieved in the group of patients who had undergone macroscopic total excision. Occipital lobe was the lobe least frequently involved while involvement ratios of other lobes were comparable. General treatment strategy is the removal of as much tumor as possible followed by postoperative RT.

Glial Kökenli Tümörlerde Tedavi Sonuçlarýmýz (145 Hasta)

Amaç: Beyin tümörlerinin yaklaþýk %40-50 gibi büyük bir bölümünü oluþturan glial tümörler ¡yerleþim yerleri ve histopatolojik alt gruplarý göz önüne alýndýðýnda prognoz açýsýndan oldukça farklýlýklar gösteren malignité grubunu oluþturmaktadýr. Bu çalýþmada, kliniðimize, 1990-1999 yýllarý arasýnda baþvuran glia kaynaklý tümörü bulunan 145 hasta sað kalýmý etkileyen faktörleri tespit etmek için retrospektif olarak deðerlendirilmiþtir.
Gereç ve Yöntem: Astrosit kökenli 11 hasta, oligodendroglia kökenli 14 hasta, ependim kökenli 7 hasta, primitif hücre kökenli 13 hasta. Erkek hasta 77, kadýn hasta 68. (Erkek/Kadýn: 1.1 ) En sýk görülen yaþ grubu; 31-40 yaþ grubudur. 52 hastaya sýýbtotal, 61 hastaya total ekstirpasyon (%42), 4 hastaya lobektonýi uygulanmýþtýr. 33 hastaya primer tümör bölgesine, 91 hastaya total kranial, 9 hastaya kraniospinal eksterýýal radyoterapi uygulanmýþtýr. Hastalarýn ortalama takip süresi 26 aydýr. G 1-2 hastalar için ortalama takip süresi 31 ay, G 3 için 21 ay, G 4 için 16 ay. Subtotal rezeksiyon olanlarýn 26 ay, total rezeksiyoýý olanlarýn 34 ay, lobektonýi uygulananlarýn 10 ay takip süreleri vardýr.
Sonuç: en iyi sonuçlar makroskopik total eksizyon ile elde edilmiþtir. Oksipital lob en az tutulmuþ, diðer loblar eþit tutulmuþtur. Tedavide genel yaklaþým, en fazla tümör dokusunun çýkarýlmasý ve radyoterapi uygulanmasýdýr.