Advances in treatment of gliomas

Published on December 29, 2016   49 min

A selection of talks on Clinical Practice

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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.
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.
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.
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.