Abstract
After studying the recent literature, the authors have summarized the latest published surgical procedures, and radio- and/or chemotherapeutic regimens for the management of malignant gliomas. Study of this data has yielded the facts listed below. The median survival time (MST) of cases treated only by surgery was 4 to 5 months, whereas the MST of cases treated by combining surgery with radiation was 10 months, and that of cases given surgery, radiation, and chemotherapy was 14 months. Further, several innovative therapeutic approaches have recently been attempted, such as interstitial irradiation, based on an after-loading method, and intra-operative radiation. Also, by using a heavily charged particle, a new radiation method with different characteristics from the γ-ray has been developed. Additionally, so as to achieve an autologous bone marrow rescue, an intra-arterial injection and high-dose chemotherapy have been employed to deliver a higher concentration of drugs into the targeted brain tissue. The results by all these recent approaches are described. Finally, based on the assumption that an ideal model providing the tumor kinetics of a malignant glioma has been developed, the authors compare the beneficial effects of radiation and chemotherapy. They emphasize that radiation has no advantage over other therapies for treating a malignant glioma, and that in finding a cure, a chemotherapy that has the capability of influencing the total nervous system is needed.
