Radiation Necrosis of a High-grade Glioma

摘要

A 64 year old male was referred to the neurosurgical serviceat Rhode Island Hospital for evaluation of a left frontal mass.Given proximity of the lesion to eloquent cortex, resectionwas not performed and a histopathologic diagnosis of gradeIII anaplastic oligoastrocytoma was made through biopsy. Thepatient was enrolled in an experimental treatment protocol thatincluded Paclitaxel Poliglumex (PPX; a microtubule stabilizerand mitotic inhibitor with a radiosensitization index of 4-8),temozolomide, and radiation. The patient also underwent twocycles of maintenance temozolomide therapy and a third cycleof dose-intensive temozolomide therapy. Serial MR imagingwith perfusion-weighted imaging was performed at multipletime points throughout treatment.