Radiation therapy approach in gliomatosis cerebri - Case reports and literature review

Gliomatosis cerebri is defined as a remarkably diffuse glioma, characterize d by widespread infiltration of the central nervous system. Clinicopatholog ic characteristics and imaging findings have been published but valid class ification remains controversial. Few reports exist regarding therapeutic op tions in gliomatosis cerebri. Here we review data on 17 patients treated wi th radiation therapy extracted from the literature, in which we focus our a ttention on available details of irradiation and clinical outcome and prese nt the results of three additional patients treated at our two institutions . Radiologic-pathologic correlation in gliomatosis cerebri indicates that t umor delineation should be based on T2-weighted MRI. Radiation therapy in g liomatosis cerebri is associated with a temporary improvement in or stabili zation of clinical symptoms in the majority of cases. Duration of improveme nt was greater than or equal to 6 months in 50% of treated patients. Surviv al from onset of symptoms was 23.8 months (range 8-42). Considerable variat ion in the natural course of the disease precludes conclusions regarding th e impact of radiation therapy on survival.