
Contents
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Introduction Introduction
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Problems unique to patients with brain tumours Problems unique to patients with brain tumours
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Types of primary CNS tumours Types of primary CNS tumours
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Treatment of non-glial tumours Treatment of non-glial tumours
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The gliomas The gliomas
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Low-grade gliomas Low-grade gliomas
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Low-grade glioma: case histories Low-grade glioma: case histories
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Analysis Analysis
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High-grade gliomas High-grade gliomas
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Growth pattern and growth rate of high-grade gliomas Growth pattern and growth rate of high-grade gliomas
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Chemotherapy for glioma Chemotherapy for glioma
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High-grade glioma: case histories High-grade glioma: case histories
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Analysis Analysis
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Presentation of patients with primary brain tumours Presentation of patients with primary brain tumours
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Initial presentation Initial presentation
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Presentation at relapse Presentation at relapse
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Symptoms not caused by relapse Symptoms not caused by relapse
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Early deterioration after radical radiotherapy Early deterioration after radical radiotherapy
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General management issues General management issues
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Management of patients with relapse Management of patients with relapse
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Outcome of patients receiving palliative radiotherapy Outcome of patients receiving palliative radiotherapy
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The patient pathway from presentation to death The patient pathway from presentation to death
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Pituitary hormone dysfunction as a late side-effect of radiotherapy Pituitary hormone dysfunction as a late side-effect of radiotherapy
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Shape of the glioma patient population survival curve Shape of the glioma patient population survival curve
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Future strategies to improve treatment for patients with glioma Future strategies to improve treatment for patients with glioma
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Improving tumour control Improving tumour control
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Reduction of side-effects of treatment Reduction of side-effects of treatment
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Palliative and supportive care Palliative and supportive care
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Dexamethasone in the management of gliomas Dexamethasone in the management of gliomas
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Presentation and surgery Presentation and surgery
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Dexamethasone during radiotherapy Dexamethasone during radiotherapy
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Dexamethasone dose after radiotherapy Dexamethasone dose after radiotherapy
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Strategy for dose reduction Strategy for dose reduction
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Strategy for dose increase at the time of relapse Strategy for dose increase at the time of relapse
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Stopping dexamethasone as a therapeutic strategy Stopping dexamethasone as a therapeutic strategy
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Dexamethasone and anticonvulsants Dexamethasone and anticonvulsants
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Acknowledgements Acknowledgements
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References References
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Further Reading Further Reading
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1 Management of Primary Brain Tumours
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Published:July 2004
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Abstract
Neuro-oncology is the most difficult area for patients, family, and staff. Of all cancers, gliomas are one of the most devastating cancers, and which posit unique problems and challenges. Primary central nervous system (CNS) tumours affect people of all ages. They are prevalent in children, and the secondmost leading cause of death in children. CNSs are the third death-causing disease in adolescents and in adults. Compared to other solid tumours such as lung, breast, or prostate cancer, primary CNS tumours cause greater incidence of mortality. This chapter does not discuss the management of patients with brain metastases, but focuses on the problems unique to patients with brain tumours and the different types of primary CNS tumours. The succeeding sections of the chapter concentrate on the major problem of patients with malignant gliomas. Discussed as well are the symptoms prevalent in patients with brain primary CNS tumours and the general management issues concerning such patients.
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