The Diagnosis and Management of Malignant Gliomas
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The treatment of malignant gliomas remains one of the great challenges in clinical medicine. The most aggressive form of malignant glioma is glioblastoma multiforme (GBM), which is also the most prevalent primary central nervous system tumor. Many investigator initiated studies related to the treatment of malignant gliomas are currently underway in this country and throughout the world. One organization conducting such research is Carolina Neurosurgery and Spine Associates in Charlotte, North Carolina, the nation's largest community-based neurosurgical group. Dr. Anthony L. Asher, MD, FACS directs a research staff at CNSA that is presently involved in numerous clinical trials related to brain tumors and other neurosurgical disorders. During a ten-week internship under the guidance of Dr. Asher, I became involved in an ongoing investigator initiated study designed to assess the efficacy of a combination of therapies in the treatment of malignant gliomas. This study used temozolomide as a neoadjuvant treatment with chemo-radiotherapy and Gliadel ® (BCNU) wafers. In addition to assisting with data collection related to this study, I was involved in other activities during this experience including independent research, observation during procedures, and participation in patient care conferences. What follows is a summary of malignant gliomas treatment options associated with these tumors, an overview of clinical trials and a detailed description of the protocol, Temozolomide as Neoadiuvant and Chemoradiotherapy Following Resection and GLIADEL® Wafer Placement in Patients with Newly Diagnosed High-grade Glioma. Additional concepts that were explored during this internship, in addition to and other work-related experiences, are detailed in the SIP journal.