부산대학교 도서관

PURPOSE: Comparison between aggressive surgical approach versus conservative therapy following biopsy for high grade gliomas. MATERĠAL and METHODS: We present two cases of patients with high-grade gliomas, the different treatment they underwent and their follow up. RESULTS: Case I A 54-year-old patient was diagnosed with glioblastoma multiforme and after stereotactical biopsy, combined radiotherapy and chemotherapy was followed, since surgery was excluded due to size and location. He was hospitalized twice after treatment for 20 days for symptoms such as hemiplegia, disorientation and dysarthria. Today he has a satisfactory physical activity and quality of life. Imaging studies show not only a stable size of the neoplasm, but even a local reduction. Case II A 33-year-old patient was diagnosed with a neoplasm of the right hemisphere and the treatment was decided to be total surgical removal. Biopsy concluded to an anaplastic oligodendroglioma (WHO grade III) and radiation therapy and chemotherapy was started. He developed ARDS after 10 days and admitted to the ICU and later needed hospitalization in the ward. Today, little improvement of the neurologic deficit is observed, while prolongation of survival is still uncertain CONCLUSĠON: Resection of a high grade glioma, although the only choice when debulking is necessary, may not relieve symptoms and may also cause a further neurologic deficit. This treatment might be preferable in young, low-risk patients, although it carries intraoperative risks and postoperative complications. On the other hand, stereotactical biopsy is less intervening, requires usually less time of hospitalisation and serious complications are rarely attributed to this procedure. It is preferred in older, neurologically intact or high-risk patients, when lesions are deeper or smaller. [ABSTRACT FROM AUTHOR]