Glioma Treatment

Glioma is the most common primary tumor of the brain or spinal cord. The treatment in Israel is planned individually based on the specific type of tumor, its size, and location.

Neurosurgeons, neuro-oncology, radiology, and other specialists at Herzliya Medical Center plan treatment for each individual case.

Classification of Gliomas

Depending on the cells that formed the tumors, gliomas are divided into several types:

• Astrocytoma
• Ependymoma
• Oligodendroglioma
• Optic nerve glioma
• Mixed gliomas, such as oligoastrocytoma

Astrocytoma is among the highest in the frequency of gliomas. They, in turn, are classified by grade, which is determined by the number of atypical (undifferentiated) cells and necrotic foci. Treatment of glioma in Israel is planned in accordance with the histological tumor type and grade. For example, low-grade astrocytoma which grows slowly may be subjected to surgical removal, and in some cases, doctors recommend confine medical supervision.

Anaplastic astrocytoma and glioblastoma – poorly differentiated tumors – require surgical removal, as well as conservative measures: chemotherapy and / or radiotherapy. These tumors often recur, and their prognosis is rather unfavorable.

Diagnosis of gliomas involves determining the histological tumor type and the degree of malignancy by biopsy.

Glioma Symptoms

With the localization of glioma in the brain the following symptoms may occur:

• Headaches
• Seizures
• Nausea, vomiting
• Visual disturbances
• Sensory-motor impairments
• Speech disorders
• Change in behavior

Glioma Diagnosis

The diagnosis of glioma is carried out by tumor imaging with an estimation of its size and location, which intends to establish the extent of the presence of neoplasms affecting the functions of the central nervous system, blood circulation, and circulation of cerebrospinal fluid.

• Magnetic resonance imaging (MRI). With the MRI image obtained structures of the brain and spinal cord can be analyzed. MRI is the “gold standard” for diagnosis. Treatment of glioma in Israel also includes repeated MRI procedures for the assessment of the disease. Intraoperative MRI is used for navigation during surgery to remove the tumor.
• Computed tomography (CT). CT reveals bleeding in the tissues of the tumor and its infiltration into the bone tissue
• Magnetic resonance spectroscopy. This technique is used to identify biochemical features of the tumor and in accordance with the findings a more suitable treatment plan can be devised.
• Positron emission tomography and single-photon emission computed tomography. Both techniques allow us to estimate the state of brain structures involved in the tumor process.
• Angiogram. Verification is used to evaluate the blood supply of the tumor and adjacent structures.
• Biopsy. The process of obtaining a small sample of tumor tissue and its pathological examination. Results of a biopsy are needed to confirm the diagnosis, determine the type of tumor and its degree of aggressiveness. At Herzliya Medical Center when conducting a biopsy, a Neuropathologist participates in the diagnosis; a specialist in a sampling of biological material from the brain.

Glioma Treatment at HMC, Israel

Surgical treatment of gliomas

Surgical treatment of glioma in Israel is carried out using modern neurosurgical techniques:

• Computer-assisted navigation
• Brain surgery in wakefulness
• Intraoperative MRI

The objective of the surgeon during surgery is tumor resection to the maximum extent while maintaining the integrity of critical brain structures.

Radiotherapy

Modern radiotherapy techniques allow for a significant portion of patients to stop tumor growth and achieve remission, and in some cases, they offer a cure for cancer.

Radiotherapy techniques include :

• External beam radiotherapy, including three-dimensional conformal
• Stereotactic radiosurgery which treatment focuses on targeting tumors without damaging healthy tissue. Tumor tissue is exposed to ionizing radiation that is directed at different angles. Stereotactic surgery has proven successful in treating neoplasms of the brain, of which neurosurgeons are unable to perform a radical resection in conventional surgery.
• Fractional stereotactic radiotherapy

Chemotherapy

For the treatment of gliomas, chemoradiotherapy is used; a combination of radiation and chemotherapy.

Experimental treatments of glioma

At Herzliya Medical Center Oncology Department, the treatment of glioma applies the latest techniques, the effectiveness of which has been confirmed by repeated clinical trials. These include biological therapy, encouraging the immune system to attack cancer tumors, and molecular targeted therapy, with a selective effect on malignant cells.