Expert: Claes-Gustaf Nordquist, M.D. - 10/13/2011

Question
QUESTION: 31 year old female patient with no signs or symptoms , found to have Brain tumour when MRI was being done for something else. Tumour in Right Frontal lobe. Open biopsy shows it to be grade 2 glioma. @nd surgery done and whole tumour removed - at no tumour seen on post surgical MRI. Does she need Radiotherapy  now?

ANSWER: Different doctors may have different opinions about this but I do suggest that radiation therapy should be given now. When there is as little as possible of any tumour remaining the therapeutic effect of radiation is probably at its best.



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---------- FOLLOW-UP ----------

QUESTION: The neurosurgeon suggests to wait and repeat MRI in 3 months and 6 months. If any activity is noted then may be, go for radiation. Localised radiation would be better but not available here. Would Radiation now trigger the cells to become more malignant - after all the gliomas are known to become grade 3?

Answer
Please see my response to your evaluation. Well that is one way of doing it. Yes stereotactic radiation is MUCH better - I think a GammaKnife is available in New Delhi but I do not know what costs that are involved. Radiation therapy may increase the risk that the tumor may eventually become more malignant (grade 3 or 4) but that risk exists - as you have mentioned yourself - to some extent whatever you do. Also development to more malignancy takes time. So that would hardly happen immediately.




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