ABTA primer excerpt Copyright ABTA
Anaplastic Astrocytoma
also called Malignant Astrocytoma or Grade III Astrocytoma
An anaplastic astrocytoma is a grade III tumor. Astrocytomas often contain a mix of cells and cell grades, but brain tumors are graded by the highest grade (most abnormal) cell seen in the tumor. These tumors tend to have tentacle-like projections that grow into surrounding tissue, making them difficult to completely remove during surgery. The word “anaplastic” means malignant, and because of this, treatment for an anaplastic astrocytoma may be more aggressive than treatment for a lower grade tumor.
The treatment options your doctor outlines will be based on the size and location of the tumor, what it looked like under the microscope, if and how far the tumor has spread, any previous treatment, and your general health. Generally, the first step in the treatment of anaplastic astrocytomas is surgery. The goals of surgery are to obtain tumor tissue for diagnosis and treatment planning, to remove as much tumor as possible, and to reduce the symptoms caused by the presence of the tumor. There are some circumstances, such as certain medical conditions or concerns about the location of the tumor, in which a biopsy may be done in place of surgery. The tissue obtained during the biopsy is then used to confirm the diagnosis.
Because the tentacle-like cells of an astrocytoma grow into the surrounding tissue, these tumors cannot be totally removed during surgery. Partial removal can help decrease symptoms; the tissue obtained during that surgery confirms the type of tumor. Radiation is then used to treat the remaining tumor. There are several forms of radiation therapy available – conventional external beam radiation, focused radiation or stereotactic radiosurgery, implanted radiation, or conformal radiation. Your radiation oncologist will determine which is best for your particular tumor.
Some treatment plans include the use of chemotherapy for anaplastic astrocytoma. BCNU, CCNU, procarbazine, cisplatin, and temozolomide are commonly used drugs. Some clinicians recommend the use of chemotherapy prior to radiation; in these circumstances the chemotherapy may reduce the amount of tumor to be treated, and may serve as a radiation sensitizer. Other treatment plans may call for the implantation of biodegradable wafers containing BCNU into the cavity created during tumor removal. Still other physicians choose not to use chemotherapy for the initial tumor, “reserving” it for re-growth if necessary.
New drugs, new drug combinations, and new ways of delivering those drugs are being studied; these treatments are offered in organized research programs called clinical trials. Many clinical trials are available for anaplastic astrocytomas – both as initial treatment and as treatment for a recurrent tumor. Many of those clinical trials can be found through the Cancer Information Service at 800-422-6237.
Anaplastic astrocytomas tend to recur, and when they do, they may regrow as a higher grade tumor. Treatment is based on the grade of tumor at recurrence.