Adult Brain Tumor Treatment Information for Physicians

Important: This information is intended mainly for use by doctors and other health care professionals. If you have questions about this topic, you can ask your doctor, or call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237).

ADULT PINEAL PARENCHYMAL TUMOR

These diverse tumors require special consideration. Pineocytomas are slow growing and carry variable prognoses for cure. Pineoblastomas are more rapidly growing and have a worse prognosis.

Depending on the degree of anaplasia, pineal astrocytomas vary in prognosis. Higher grades have a worse prognosis.

Treatment options:

Standard:

1. Surgery plus radiation therapy for pineocytoma and lower grades of astrocytoma.[1,2]

2. Surgery plus radiation therapy and chemotherapy for pineoblastoma and higher grades of astrocytoma.[1,2]

Patients with brain tumors that are either infrequently curable or
unresectable should be considered candidates for clinical trials that
evaluate radiosensitizers, hyperthermia, or intraoperative radiation therapy in conjunction with external-beam radiation therapy to improve local control of the tumor and/or for studies that evaluate new drugs and biological response modifiers following radiation therapy.

1. Stein BM, Fetell MR: Therapeutic modalities for pineal region tumors. Clinical Neurosurgery 32: 445-455, 1985.
2. Rich TA, Cassady JR, Strand RD, et al.: Radiation therapy for pineal and suprasellar germ cell tumors. Cancer 55(5): 932-940, 1985.

ADULT CENTRAL NERVOUS SYSTEM GERM CELL TUMOR

The prognosis and treatment of germ cell tumors depends on the histology, location, presence and amount of biological markers, and surgical resectability.[1,2]

References:

1. Edwards MS, Hudgins RJ, Wilson CB, et al.: Pineal region tumors in children. Journal of Neurosurgery 68(5): 689-697, 1988.
2. Lindstadt D, Wara WM, Edwards MS, et al.: Radiotherapy of primary intracranial germinomas: the case against routine craniospinal irradiation. International Journal of Radiation Oncology, Biology, Physics 15(2): 291-297, 1988.

ADULT CRANIOPHARYNGIOMA

Craniopharyngioma is often curable.

Treatment options:

Standard:

1. Surgery alone if totally resectable.[1]

2. Debulking surgery plus radiation therapy if unresectable.[2]

1. Baskin DS, Wilson CB: Surgical management of craniopharyngiomas: a review of 74 cases. Journal of Neurosurgery 65(1): 22-27, 1986.
2. Rajan B, Ashley S, Gorman C, et al.: Craniopharyngioma - long-term results following limited surgery and radiotherapy. Radiotherapy and Oncology 26(1): 1-10, 1993.

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