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Printable Handouts
Navigable Slide Index
- Introduction
- Lecture format
- Brain cancer demographics
- Incidence by age
- Brain tumour survival
- Survival trends over time
- WHO grading of CNS tumours
- WHO grading of CNS tumours: glioblastoma
- WHO grading of CNS tumours: subdivision
- WHO grading of CNS tumours: malignancy
- WHO grading of CNS tumours: transformation
- WHO classification system
- Astroglioma vs. oligodendroglioma
- Genetics of gliomas
- IDH mutations
- Prognostic relevance of IDH 1/2 mutations
- Analysis of 35 IDH wt astrocytomas
- Clinical scenario
- Low-grade vs. high-grade
- Need for tissue diagnosis
- 1p19q deletion
- 1p19q status
- Low-grade glioma
- Natural history
- Insular astrocytoma
- Management options
- Natural history study
- Automatic contouring
- Does growth predict transformation?
- Results: Transformers vs. non-transformers
- Growth rates
- Initial tumour growth rate (ITGR)
- Median split by ITGR
- ITGR and probability of transformation
- Perfusion imaging
- Perfusion imaging data
- MRI predictors of transformation
- Surgery vs. surveillance
- Biopsy vs. resection for low-grade glioma
- Phase II prospective observational study
- Can we make surgery safer?
- Preoperative fMRI/DTI
- Suitable for surgery? (1)
- Suitable for surgery? (2)
- Transverse section
- Coronal section
- Sagittal section
- Successful surgery
- Language and motor tests
- Before and after surgery
- Radiotherapy: early vs. delayed
- EORTC 22845: timing of RT
- Progression-free survival
- Overall survival
- Radiotherapy: delayed toxicity
- Role of chemotherapy
- Role of chemotherapy in gliomas
- 22033-26033: study scheme
- Primary analysis: progression-free survival
- 1p status: progression-free survival
- Role of adjuvant chemotherapy
- Summary: LGG current management
- High-grade glioma
- Radical surgery failure in malignant glioma
- Glioblastoma (GBM)
- Surgery for glioblastoma
- Fluorescence guided resection
- Fluorescence guided resection (images)
- Radiotherapy & Temozolomide: trial design
- Results: overall survival
- MGMT status
- Effect of MGMT status on survival
- Management of recurrent GBM
- Bevacizumab (Avastin)
- Avastin and ‘pseudo’ response
- Trial results
- Immunotherapy
- Immune checkpoint inhibitors
- DC Vax
- Summary: HGG current management
Topics Covered
- Burden of disease and survival
- Pathological grading and molecular genetics
- Low-grade gliomas: controversies in treatment
- High-grade gliomas: advances and limitations in current therapies
- Future directions
Talk Citation
Rees, J. (2024, September 17). Advances in treatment of gliomas [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 22, 2024, from https://doi.org/10.69645/XFUF2044.Export Citation (RIS)
Publication History
Financial Disclosures
- Dr. Jeremy Rees has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
A selection of talks on Neurology
Transcript
Please wait while the transcript is being prepared...
0:00
My name is Dr. Jeremy Rees.
I work as a Consultant Neurologist
and Neuro-Oncologist
at the National Hospital for Neurology
and Neurosurgery in London
and I'm going to be speaking
on the new advances
in treatment of gliomas.
And I'm going to restrict the talk
to the treatment of adult gliomas.
0:21
The format of the lecture
is that I'm going to give an overview
of the burden of disease and survival
from brain tumours in general
and then specifically talk about
the classification
according to the WHO's scheme
of brain tumours
and how we divide them up
into four distinct grades.
I'm then going to talk a little bit
about the molecular genetics
of these tumours
and how they are important
in determining prognosis,
and then I'm going to focus
the rest of the talk
on the controversies
in treatment of low-grade gliomas
followed by the advances
and limitations of current therapies
in high-grade gliomas,
and briefly finish
with a look at future directions
in the management of high-grade gliomas.
1:05
In terms of general cancer,
brain tumours occupy
a fairly small proportion
of the overall burden of cancer.
Recent data suggests that
there are approximately 4,000 cases
of brain cancer in a total of just
under 300,000 now,
so this is a relatively small proportion,
only about 2% of cancer in general.
However, brain cancer represents
the leading cause of life lost
from cancer
and remains one of the most
challenging cancers to treat.
1:38
Unlike most cancers in adults,
brain cancer affects all age groups
all the way through
from very young children
to elderly adults.
As a general rule,
the incidence of cancer increases by age
and reaches a maximum in the 7th decade,
i.e. between 60 and 70 years old.
Interestingly,
there is an almost universal agreement
that males are affected
more than females.