Expert: Claes-Gustaf Nordquist, M.D. - 5/29/2010

Question
I was wondering after a dianosis antilplastic oligoastrocypoma, what other chemotherapy drugs besides temodar. He was on this drug, pill form for 49 days, 18 monthly cycles 400mg, 5 days a month. He is now finished with this drug, He also had the maximum dose of radiation for 6 weeks, 6000 rad`s total. So he can not have anymore. The diagnosis was based on a neoplazm parcetal lobe. He started out with one tumor, he now has 3. He is about to start on Avaistin I.V...I guess I want to know if this chemotherapy drug does not work what other drugs if any would be available to him. That is my first question.
My second question, Average life expectancy- prognosis.
My third question is, matastizm, how likely is it to spread to other parts of the body? What would I look for?
And finally and fourthly, What are we to expect as this disease advances to the end of his days, please be as specific as possible, we want to know, and so does he.
Thank you for your time.
Sincerely,
Linda...
P.S. He was 15 when this began, he was given two years, which would make him 17 in July, also the two year mark as he was diagnosed in July 2008.

Answer
To give you a good estimate I need to know what GRADE it is assumed his tumor has. Like all brain tumors the prognosis of an anaplastic astrocytoma is closely correlated to grade which since it is an anaplastic tumor should be high but I need as good information on that point as possible. Brain tumors rarely metastasize to other parts of the body. They usually remain within the central nervous system (brain & spinal cord). Due to the so called blood-brain barrier (a physiological barrier that makes it difficult to bring many drugs from the circulating blood into the brain & spinal tissues) the number of chemotherapy drugs that can be used to treat brain tumors is severely limited. Temodar is the one most widely used. Avastin is more experimental. There are not many more available at present.
If you can provide the information I asked for I'll try to evaluate the whole situation as you have asked me to do at the best of my ability and as quickly as possible.


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