Recurrent

ABSTRACT: Gliomas are the most frequent primary brain tumors. Most gliomas require aggressive combination of therapy with radiotherapy and chemotherapy after maximal surgery. Recurrent glioma is a significant deterioration in an existing neurological deficit. The current study aimed to prospectively assess the clinical characteristics of first and second presentations of patients, the optimal treatment among the available modalities for recurrent glioma and to illustrate the highly selected individuals with recurrent glioma and the determinants of treatment modalities and patients recruited for. Hence a prospective study on 24 patients with recurrent cerebral glioma carried out in the Neurosurgical Teaching Hospital in Baghdad/Capital of Iraq during Feb. 2009 to Feb. 2011. Twenty one patients (87.5%) were exposed to second operation directed at their tumor site, and had mean survival of 50 weeks, while 3 patients (12.5%) had been treated by chemotherapy had survived for a mean of 11 weeks. Reoperation was associated with a mortality rate of (4.1%). Best survival and good outcome was found in those who had good neurological performance and they were relatively young age. Malignant transformation and dedifferentiation was found in (75%) of cases. In conclusion, no curable treatment regarding recurrent glioma is definite, but reoperation is feasible and can be carried with less morbidity and mortality when considering a good selection criteria of the patients, preserving chemotherapy for those who are not amenable for surgery.