الفهرس 
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Abstract
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It is a review of the effect of chemotherapy on
the manegmentof brain tumours.
First chapter reviewed the classification of brain
tumours where there was several classifications since
discovering the glia, but- the most widely accepted histological
classification in that pUblished by W.H.O.
1979.
Second ~hap~er give short account about growth
kinetic s of brain tumours include cell eyeIe of caneer
cells where it 18 qualitatively the same as that of normal
cells which in turn is divided into four phases,
during which synthesis and dublication of RNA,DNA,and
prot eins occured together wi th actual physical devision
of the cells.
After mitotic devision of the cells, it may enter
resting phase during which. the:y are relatively inaetive
:.lnd insensetive to many chemotherapeutic agents.
The doubling time of 8 tumour - the interval during
”.-deh the Volumeor weight of’ the tumour doubles - is
frequently muchlonger than the generation time which
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is the combined d~ration of the Iour phases of cell cycle.
The third chapter discuss extensively the canc er
chemetherapeutic agents as regard their classification,
physical properties, dosage regimens, ability to ~ross
blood brain barrier and their route of excretion together
with their plasma half life •
. The following chapters include the results ot some
clinical trials in the manegmen t of brain tumours-both
primary and secondarY - with different chemotherapeutic
agents after surgical excision with or without radiotherapy
in both adult a and children. Most trials include
combined chemotherapeutic agents and some include
single agent.
Clinic al trials with chemotherapeutic agents in the
manegmentof meningeal laukemia also included in these
chapters.
Complications of chemetherapeutic agents during and
after treatment of brain tumours were discussed in last
Chapter. MOstot these complications were haematologic;
gastro-intestinal, neurological, and occular, together
with some allergic reactions depending on the type ot
drug used.
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from the previous, we C~l concluded that,
t reatment of brain tumours, like treatment of
cancer in general, involves killing and remoVing neoplastic
cells.
Chemotherapy of brain tumours must be considered
as an adjunct to surgery and radiation, not as a distinctly
diff’ erent treatment to be applie d when th e
other two fail.
To he most e~~ective, chemotherapy must be utilized
soon after operation, or in radio sensitive tumour,
soon atter radiation, before the tumour has grONnlarge
and the proportion of susceptible ceJ.le declines.
Mali gnan t brain tumours are composad of hetrogenous
cell population, so, combination chemotherapy has definite
anti-tumour activity superior to therapy with
single ch’ug al one.
Tumours·of lower grades of malic;nancy (astrocytoma
III, mal.ignant ependymoma,medulloblastoma) has a statistically
signi£icant higher BJW (Nitrosourea) sensetivl~
y and are sensetive to more d:rugs, than tumours of
higher grades of tr~lignancy (astrocytoma IT, gliobla-
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stoma multiform).
Amongpatients with malignant Glioma treated with
radiation the~apy and chemotherapy, the young tend to
survive lonbsr than the old.
Older age at diagnosis, early stages of the tumour
with no dissemination, possibly total surgical resection
are good prognostic factors in children with medulloblastoma.
Children whose medulloblastoma show cellular
di:f’efrentiation have a poor prognosis than these
that do not t even when other factors of prognostic importance
are considered.
Favo:.lrable results were obtained in the treatment
of pa tients with recurrent primary anaplastic brain
tumours using Diaziquone (AZQ) compare with those obtaine
d u.sing the ni tros aurea or procarbazine as single
agents, and it was found that tumour regression was
better in patients without prior chemotherapy than
those with prior chemotherapy.