Neuro-Oncology: A Brief Review
Gokaraju Rangaraju College of Pharmacy, Hyderabad, Telangana, India
- *Corresponding Author:
- Revathi K
Gokaraju Rangaraju College of Pharmacy
Hyderabad, Telangana, India
E-mail: [email protected]
Received date: 11-07-2016; Accepted date: 22-07-2016; Published date: 28-07-2016
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Tumor is an abnormal cell formed in the brain. Tumors are generally malignant and benign. The study of brain and spinal cord related tumors or neoplasms are Neuro-Oncology. These tumors are generally life-threatening and very dangerous. A tumor that arises from glial cells in the brain or spinal cord is glioma. Majority of all the malignant brain tumors are of glioma. The glioblastoma multiforme has been classified by WHO as Glioblastoma or Grade IV Astrocytoma. Brain has glial cells which are star shaped and are known as astrocytes. The types of cancer of brain that originate from such cells are the astrocytomas.
Neuro-oncology, Tumor, Brain, Glioma, Glioblastoma, Astrocytoma.
Tumor is an abnormal cell formed in the brain. Tumors are generally malignant and benign. The study of brain and spinal cord related tumors or neoplasms are Neuro-Oncology [1-3]. These tumors are generally life-threatening and very dangerous. Symptoms are based on tumor size, type and location or when the tumor presses a part of the brain [4-6]. Untreated tumors are generally few months to a year percentage of survival. Depending on the patient’s condition, immune system, treatments being used and the type of malignant tumor affected, survival chance varies from year or more [7-8]. General treatment is done by surgery, but these brain tumors easily regenerate and emerge from remission easily. Most often, meningitis occurs in women where as the primary brain tumors occur in men [9-11]. Tumors occur at any age However, the most known malignant cancers of brain are gliomas, glioblastoma and astrocytoma [12-14].
Types of Neurological Cancers
A tumor that arises from glial cells in the brain or spinal cord is glioma [15-18]. Majority of all the malignant brain tumors are of glioma. Most commonly, gliomas occur in the brain [19-21]. One of the common malignant brain cancers is the gliomas of the brain stem and pons [22-25]. Gliomas are categorised based on grade (low and high grade based on pathologic evaluation of the tumor), location (based on above or below tentorium, the brain membrane) and cell type (astrocytoma’s) [26-29]. Symptoms include nausea, seizures, cranial nerve disorders etc.
Although causes are unknown, certain genetic disorders like neurofibromatosis and tuberous sclerosis complex are known to predispose to their development [30-33]. Treatment of such tumors depends on the type of glioma. Mostly a combined approach of surgery and chemotherapy treatment is done [34-37].
The glioblastoma multiforme has been classified by WHO as Glioblastoma or Grade IV Astrocytoma. About 15% of the brain tumors are of glioblastoma which are the aggressive cancers that begin within the brain [38-41]. The causes of this type of cancer are really unknown although some studies report genetic disorders like neurofibromatosis and prior radiation therapy [42-44]. It can be diagnosed by combination of CT scan, tissue biopsy and MRI scan . Initially non-specific signs and symptoms are seen which include headache, nausea and others which are similar to stroke . Rapid worsening of symptoms is seen which gradually progress to unconsciousness . It is only about 2-3 % from 1,00,000 develop this type of tumor. Treatment generally involves surgery or chemotherapy. Non treated tumor patients die in less than 3 months .
Brain has glial cells which are star shaped and are known as astrocytes. The types of cancer of brain that originate from such cells are the astrocytomas . This type of cancer is the most common found in the brain than the spinal cord. This type usually does not affect other organs outside brain . Generally two broad classes of astrocytoma’s have been categorised i.e., Narrow zone and Diffuse zone of infiltration .
Diagnostic Imaging of the Brain and Spinal Cord
Diagnostic angiography, magnetic resonance imaging (MRI), positron emission tomography (PET), computed tomography (CT) and myelography are the most often used for imaging studies.
Lumbar Puncture and Cerebrospinal Fluid Analysis
Cerebrospinal fluid (CSF) analysis and Lumbar puncture (LP) analysis.
The tissue obtained surgically is needed for studying the histologic diagnosis.
Surgery: As mentioned above the tissue obtained surgically is needed for studying the histologic diagnosis. With the new surgical techniques many tumors have been treated.
Chemotherapy: Use of drugs for treatment is Chemotherapy. As this procedure involves side effects, and toxicity administration of these drugs should be monitored by a supervisor.
Radiation therapy: It is considered one of the important types of treatment for not only in extending survival time but also in improving the quality of life.
Steroidal treatment: Generally corticosteroids are given to the patients with tumors having symptoms related to oedema and intracranial pressure.
Approach to Clinical Problems in Neuro-Oncology
• Fever and neutropenia
• Nausea and vomiting
• Anorexia and weight loss
• Anxiety and depression
• Mental status change
• Urinary problems
• Visual problems
• Brain tumors
• Central nervous system infections
Palliative care is the support care or also called comfort care . The intention of palliative care is to prevent or treat at the earliest stage possible when diagnosed with symptoms and side effects of the treatment . It is not to cure rather to prevent or treat and to improve the quality of life of the patients suffering from life threatening cancers .
Impact of Treatment of Tumors in Children
As mentioned earlier, if these brain tumors are not treated properly, they can be life threatening. Brian cancers are the most common type of cancers affecting children . Treatment involves chemotherapy, surgical resection and radiation therapy. Curing rates are high with the mentioned methods .
- Chrousos GP.Stress and disorders of the stress system. Nat Rev Endocrinol. 2009; 5: 374-381.
- LeShan L.Psychological states as factors in the development of malignant disease:a critical review. J Natl Cancer Inst. 1959; 22: 1-18.
- Wang C, et al.Beliefs about the causes of breast and colorectal cancer among women in the general population. Cancer Causes Control. 2010; 21: 99-107.
- Lin Y, et al.Striking life events associated with primary breast cancer susceptibility in women:a meta-analysis study. J ExpClin Cancer Res. 2013; 32: 53.
- Antonova L, et al.Stress and breast cancer:from epidemiology to molecular biology. Breast Cancer Res.2011; 13: 208.
- Ng DM and Jeffery RW.Relationships between perceived stress and health behaviors in a sample of working adults. Health Psychol. 2003; 22: 638-642.
- Cabaniols C, et al.Links between private habits, psychological stress and brain cancer:a case-control pilot study in France. J Neurooncol. 2011; 103: 307-316.
- Ramirez AJ, et al.Stress and relapse of breast cancer. BMJ. 1989; 298: 291-293.
- Correa DD,et al.Cognitive functions in low-grade gliomas:disease and treatment effects. J Neurooncol. 2007; 81: 175-184.
- Noll KR, et al. Relationships between tumor grade and neurocognitive functioning in patients with glioma of the left temporal lobe prior to surgical resection. NeuroOncol. 2015; 17: 580-587.
- Thompson SBN. Introductory Note on Volume 7 and Issue 3. J NeurolNeurosci. 2016; 7: 3
- Sequeira E and NagendranS. Neuroinformatics:A Spotlight on Various Databases and the Importance of Their Integration. Am J PhytomedClinTherapeu. 2014; 2:976-984.
- Salih LM and Kaushik A. Mini Review on Psychedelic Drugs:Illumination on the Hidden Aspects of Mind. 2013; 1: 432-444.
- Cuoco JA, et al. Hypothetical Link between Osteopathic Suboccipital Decompression and Neuroimmunomodulation. 2016; 7:S3.
- Thompson SBN. Communicating with the Motor Cortex? Cortisol and Yawning as Possible Biomarkers for the Detection of Neurological Disease. J NeurolNeurosci. 2016; 7: S3.
- Oliveira de CR, et al. Use of Bells Test in the Evaluation of the Hemineglect Post Unilateral Stroke. J NeurolNeurosci. 2016; 7:S3.
- Zhang Y, et al. Abnormal Neural Circuits Model in Central Post-stroke Pain. ActaPsychopathol. 2016; 2: 3.
- Merola J, et al. Calcified Pseudoneoplasm of the Neuraxis (CAPNON):A Lesson Learnt from a Rare Entity. J NeurolNeurosci. 2016; 7: 121.
- CerenYalniz et al. Concurrent Presentation of Neurobrucellosis and Spinal Cyst:A Case Report. J NeurolNeurosci. 2016; 7: 116.
- Zarduei A, et al. Alzheimer's Disease and Diabetes:Diffusion Tensor Imaging as a Probable Diagnostic Measure. 2016; 7: 111.
- Strong MJ, et al. Brain Tumors:Epidemiology and Current Trends in Treatment. Brain Tumors Neurooncol. 2015; 1: 102.
- Pelekasis P. Is Intense Stress Related to the Onset of Brain Cancer? Shedding Some Light on a Literature Gap. 2015; 1: e101.
- NittbyH, et al. A GFP Positive Glioblastoma Cell Line NS1-A New Tool for Experimental Studies. 2015; 1:101.
- StrongMJ, et al. Brain Tumors:Epidemiology and Current Trends in Treatment. 2015; 1: 102.
- RajeV, et al.PaediatricsSupratentorialExtraventricularEpendymoma. 2015; 1: 103.
- Taha MS andAlnemari HH. Skull Base Reconstruction with Titanium Mesh for Benign Complex Anterior Skull Base Tumors:Case Series and Review of the Literature. J Brain Tumors Neurooncol. 2016; 1: 104.
- A simple guide to the terminology and application of leucocyte monoclonal antibodies.
- Cordova JS, et al. Whole-brain spectroscopic MRI biomarkers identify infiltrating margins in glioblastoma patients. NeuroOncol.2016; 1180-1189.
- Wick W, et al.Evaluation of pseudoprogression rates and tumor progression patterns in a phase III trial of bevacizumab plus radiotherapy/temozolomide for newly diagnosed glioblastoma. NeuroOncol. 2016: now091v1-now091.
- Chang SM, Response Assessment in Neuro-Oncology (RANO):more than imaging criteria for malignant glioma. NeuroOncolPract.2015; 205-209.
- CNS Anticancer Drug Discovery and Development Conference White Paper. NeuroOncol.2015: vi1-vi26.
- Stensjoen AL, et al. Growth dynamics of untreated glioblastomas in vivo. NeuroOncol.2015: 1402-1411.
- Ellingson BM, et al.Pros and cons of current brain tumor imaging. NeuroOncol.2014; 16:vii2-vii11.
- EllingsonBM, et al. Is there a role for vaccine-based therapy in recurrent glioblastoma?NeuroOncol.2014;16: 757.
- Rajeshwari M, et al. Evaluation of chromosome 1q gain in intracranial ependymomas.J NeuroOncol.2016; 127, 2, 271CrossRef
- Piña-Garza EJ.Fenichel's Clinical Pediatric Neurology,CrossRef 2013;215.
- James AJandKulkarni AV.Brain Tumors. Neurological complications of systemic cancer. CrossRef 2012; 435.
- Luchi T, et al. Epilepsy in patients with gliomas: incidence and control of seizures.J ClinNeurosci.2015.
- Teplyuk NM, et al. Therapeutic potential of targeting microRNA-10b in established intracranial glioblastoma: first steps toward the clinic. EMBO Mol Med.2016;8: 268-287.
- Segal T. Which drug or drug delivery system can change clinical practice for brain tumor therapy.NeuroOncol.2013; 15:656-669.
- Zadeh G, et al. Highlights from the Literature. NeuroOncol. 2015: 773-775.
- Huse JT, et al. Where are we now? And where are we going? A report from the Accelerate Brain Cancer Cure (ABC2) Low-grade Glioma Research Workshop. NeuroOncol.2014: 173-178.
- Theeler BJ, et al.Moving toward molecular classification of diffuse gliomas in adults. Neurology. 2012: 1917-1926.
- Hofer S,et al. Decision making and management of gliomas: practical considerations. Ann Oncol.2012: 33-40.
- Horská A, Barker PB. Magnetic Resonance Metabolic Imaging of Glioma. SciTransl Med. 2012: 116ps1
- Dunn GP, et al. Emerging insights into the molecular and cellular basis of glioblastoma. Genes Dev.2012: 756-784.
- Dafny N and Yang PB. Interferon and the central nervous system.2005; 1-15.
- Alfred Yung WK. Moving Toward the Next Steps in Angiogenesis Therapy? NeuroOncol10: 939.
- Kirchhoff F, et al.Simian Immunodeficiency Virus and Human Immunodeficiency Virus Type 1 Matrix Proteins Specify Different Capabilities To Modulate B Cell Growth. JVirol.201488: 5706-5717.
- Strömblad LG, et al. Reoperation for malignant astrocytomas: personal experience and a review of the literature. 1993; 7: 623-633.
- Sambrook J and Michael G.Molecular cloning: a laboratory manual, Cold Spring Harbour Laboratory Press, Cold Spring Harbour NY. 1989.