MALIGNANT GLIOMAS OF THE BRAIN AND SURGICAL LIMITATIONS

Malignant gliomas are the most common intracranial primary tumours. De spite aggressive treatment strategies as surgery, radiation and chemot herapy, the vast majority of patients die about one year after diagnos is. In this article we discuss histopathological and moleculargenetic structures of glioma. We evaluate specific topographical areas of the brain with respect to tumour surgery and radical tumour exstirpation. Gross total resection versus debulking are compared regarding the medi an survival time. The importance of radiotherapy and chemotherapy subs equent to surgery will be pointed out. We conclude that to date the tr eatment of choice in malignant gliomas of the brain is multimodal and includes surgery (the extent of surgery is limited by functionally imp ortant areas), radiotherapy and chemotherapy. However, since the media n survival time averages still about one year, in the future new treat ment strategies, for example gene therapy, have to be approached.