Editing Brain tumor (section)

==Prognosis==
The prognosis of brain cancer depends on the type of cancer diagnosed. [[Medulloblastoma]] has a good prognosis with [[Medulloblastoma#Treatment and prognosis|chemotherapy, radiotherapy, and surgical resection]] while glioblastoma has a median survival of only 15 months even with aggressive [[chemoradiotherapy]] and surgery.<ref name=":12">{{Cite book |title=Central Nervous System Tumours |collaboration=WHO Classification of Tumours Editorial Board |publisher=International Agency for Research on Cancer |year=2021 |isbn=978-92-832-4508-7 |pages=39 ff |language=en}}</ref> Brainstem gliomas have the poorest prognosis of any form of brain cancer, with most patients dying within one year, even with therapy that typically consists of radiation to the tumor along with [[corticosteroid]]s. However, one type, focal brainstem gliomas in children, seems open to exceptional prognosis and long-term survival has frequently been reported.<ref>{{cite web |url=http://www.childhoodbraintumor.org/index.php?option=com_content&view=article&id=57:brain-stem-gliomas-in-childhood&catid=34:brain-tumor-types-and-imaging&Itemid=53 |title=Brain Stem Gliomas in Childhood |publisher=Childhoodbraintumor.org |access-date=17 February 2012 |url-status=live |archive-url=https://web.archive.org/web/20120309100048/http://www.childhoodbraintumor.org/index.php?option=com_content&view=article&id=57%3Abrain-stem-gliomas-in-childhood&catid=34%3Abrain-tumor-types-and-imaging&Itemid=53 |archive-date=9 March 2012  }}</ref>

Prognosis is also affected by presentation of genetic mutations. Certain mutations provide better prognosis than others. [[IDH1]] and [[IDH2]] mutations in [[glioma]]s, as well as deletion of chromosome arms 1p and 19q, generally indicate better prognosis. [[P53|TP53]], [[ATRX]], [[Epidermal growth factor receptor|EGFR]], [[PTEN (gene)|PTEN]], and [[Telomerase reverse transcriptase|TERT]] mutations are also useful in determining prognosis.<ref name=":4" />

===Glioblastoma===
{{Main|Glioblastoma}}

[[Glioblastoma]] is the most aggressive ([[grading of the tumors of the central nervous system|grade 4]]) and most common form of a malignant primary brain tumor. Even when aggressive multimodality therapy consisting of radiotherapy, chemotherapy, and surgical excision is used, median survival is only 15–18 months.<ref name=":12" /> Standard therapy for glioblastoma consists of maximal surgical [[Segmental resection|resection]] of the tumor, followed by radiotherapy between two and four weeks after the [[craniotomy|surgical procedure]] to remove the cancer, then by [[temozolomide|chemotherapy]], such as [[temozolomide]].<ref name=":2">{{cite journal | vauthors = Sasmita AO, Wong YP, Ling AP | title = Biomarkers and therapeutic advances in glioblastoma multiforme | journal = Asia-Pacific Journal of Clinical Oncology | volume = 14 | issue = 1 | pages = 40–51 | date = February 2018 | pmid = 28840962 | doi = 10.1111/ajco.12756 | doi-access = free }}</ref> Most patients with glioblastoma take a [[corticosteroid]], typically [[dexamethasone]], during their illness to relieve symptoms. Experimental treatments include [[targeted therapy]], [[radiosurgery#Gamma Knife|gamma knife radiosurgery]],<ref>
{{cite web |url=http://brain.mgh.harvard.edu/patientguide.htm |title=GBM Guide – MGH Brain Tumor Center |publisher=Brain.mgh.harvard.edu |access-date=17 February 2012 |url-status=live |archive-url=https://web.archive.org/web/20120216012258/http://brain.mgh.harvard.edu/PatientGuide.htm |archive-date=16 February 2012  }}
</ref> [[boron neutron capture therapy]], [[gene therapy]], and [[Carmustine#Implants|chemowafer implants]].<ref>{{cite journal |last1=Tai |first1=Chien-Kuo |last2=Kasahara |first2=Noriyuki |title=Replication-competent retrovirus vectors for cancer gene therapy |journal=Frontiers in Bioscience |date=January 2008 |volume=13 |issue=13 |pages=3083–3095 |doi=10.2741/2910 |pmid=17981778 }}</ref><ref>{{cite journal | vauthors = Murphy AM, Rabkin SD | title = Current status of gene therapy for brain tumors | journal = Translational Research | volume = 161 | issue = 4 | pages = 339–54 | date = April 2013 | pmid = 23246627 | pmc = 3733107 | doi = 10.1016/j.trsl.2012.11.003 }}</ref>

===Oligodendrogliomas===
{{Main|Oligodendroglioma}}
[[Oligodendroglioma]]s are incurable but slowly progressive malignant brain tumors. They can be treated with [[Segmental resection|surgical resection]], [[chemotherapy]], [[radiotherapy]] or a combination. For some suspected low-grade (grade II) tumors, only a course of watchful waiting and symptomatic therapy is opted for. These tumors show co-deletions of the p and q arms of [[chromosome 1 (human)|chromosome 1]] and [[chromosome 19 (human)|chromosome 19]] respectively (1p19q co-deletion) and have been found to be especially chemosensitive with one report claiming them to be one of the most chemosensitive tumors.<ref name=":12" /><ref>{{cite journal |last1=Ty |first1=A. U. |last2=See |first2=S. J. |last3=Rao |first3=J. P. |last4=Khoo |first4=J.B.K. |last5=Wong |first5=M. C. |title=Oligodendroglial tumor chemotherapy using "decreased-dose-intensity" PCV: A Singapore experience |journal=Neurology |date=24 January 2006 |volume=66 |issue=2 |pages=247–249 |doi=10.1212/01.wnl.0000194211.68164.a0 |pmid=16434664 |s2cid=31170268 }}</ref> A median survival of up to 16.7 years has been reported for grade II oligodendrogliomas.<ref>{{cite web |url=http://www.neurology.org |title=Neurology |publisher=Neurology |access-date=17 February 2012 |url-status=live |archive-url=https://web.archive.org/web/20120219094513/http://www.neurology.org/ |archive-date=19 February 2012  }}</ref>

=== Acoustic neuroma ===
[[Vestibular schwannoma|Acoustic neuroma]]s are non-cancerous tumors.<ref>{{Cite web|url=https://www.hopkinsmedicine.org/health/conditions-and-diseases/brain-tumor/vestibular-schwannoma|title=Acoustic Neuroma (Vestibular Schwannoma)|website=hopkinsmedicine.org|access-date=19 July 2019}}</ref> They can be treated with surgery, radiation therapy, or observation. Early intervention with surgery or radiation is recommended to prevent progressive hearing loss.<ref>{{Cite web|url=https://www.uptodate.com/contents/vestibular-schwannoma-acoustic-neuroma|title=UpToDate|website=uptodate.com|access-date=19 July 2019}}</ref>