An interdisciplinary approach to avoid the overtreatment of patients with central nervous system lesions

✍ Scribed by Peter C. Burger; Bernd W. Scheithauer; Roland R. Lee; Brian P. O'Neill

• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: English
• Weight: 77 KB
• Volume: 80
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/(sici)1097-0142(19971201)80:11<2040::aid-cncr2>3.0.co;2-0

✦ Synopsis

T he diagnosis of a central nervous system (CNS) lesion as a neo- plasm often precipitates a treatment plan that includes radiation and chemotherapy. Although these modalities are effective for some CNS tumors, they also have well known side effects that are prone to appear during the long postoperative survivals of patients with low grade tumors and nonneoplastic processes. Therefore, a cautious approach to patients with CNS masses is appropriate before treatment begins. This is especially true because many of the high grade tumors for which aggressive therapy is administered are not cured thereby. Although current treatments are effective in many CNS entities, across-the-board caution in the use of adjuvant therapies rarely deprives a patient of a cure.

It has been our experience that in most situations of overtreatment, clinical, radiologic, or pathologic features suggesting a low grade or nonneoplastic lesion were present at the time of treatment planning. This article draws attention to those features in an algorithm