Expert: Claes-Gustaf Nordquist, M.D. - 7/7/2009

Question
My friend was diagnoised with Grade 3 Astrocytoma in the cerebellum on 23 March 2009.  He underwent a debulking surgery, which did not remove very much of the tumor, and has completed a six week course of chemo (temodar) and radiation.  The neurologist stated that the tumor was near his brain stem and that he couldn't remove much of the tumor because he could not differentiate healthy from diseased brain tissue.  I have several questions, first being- what is the average life expectancy with this type of tumor?  I have had a hard time finding much related to adult tumors in this region.  He is 36 years old.  Would he benifit from gamma knife radiation?  The tumor's original size was 5.5 cm, and the debulking removed only about 1cm of brain tissue.  What would be the best course of treatment to persue at this point?  He will have the radiation/chemo follow up MRI in a few weeks and we will know exactly how effective the treatment was, but I would like to have a plan prior to finding this information out.  I would greatly appreciate any guidance you can give me on this, I haven't found much information that really pertains to his situation.

Answer
Unfortunately even after debulking his tumor seems to be too big for the GammaKnife. Unfortunately in that situation the only available therapy is the one he receives at present (radiation therapy & chemotherapy). A grade 3 astrocytoma is at present incurable and eventually fatal. What his present therapy can do is a temporary relief of symptoms and an extended survival time. It is impossible to predict survival times with any precision. Both patients and tumors are individuals not identical copies/clones. But I expect his survival time - with treatment - to be around 2 years or a little more. But I can not guarantee that it will not be shorter. I'm sorry I have nothing better to tell you!