Principles of the complex therapy of gliomas in Latvia (1993-1998)

60-70 malignant gliomas of 3rd and 4th degree of anaplasia are diagnosed in Latvia every year. The basic method of treatment of malignant gliomas is their surgical evacuation using CUSA, coagulation loops, binocular operation loupes and in several stages of surgery - microscope. Detailed morphological analysis of operation material according to 7 qualitative and 1 quantitative (Ki-67 antibody detection) signs. This analysis determines in general the choice of further method of complex therapy. Most often in the cases of malignant gliomas complex fractionated radiotherapy (55-60 Gy per course, 2 Gy per procedure) and systemic chemotherapy were used. In the cases when radiotherapy is not possible because of various side reasons and PI of gliomas is less than 5% and the structure is rich in blood vessels, only chemotherapy is used. Main agent are ACNU and CeeNU. Chemotherapy is carried in 2-3 stages, 6-courses in every stage. Interval between the courses - 6 weeks, between the stages - 6 month. When the schedule is accomplished CT and MR are done. At the present time 71% of the patients after complex therapy are in the phase of remission and in 29% of cases recurrent gliomas were diagnosed. (Full text)