Anaplastic Astrocytoma (AA)

Anaplastic Astrocytomas: Symptoms, Treatment and Diagnosis

An Anaplastic Astrocytoma is a malignant type of astrocytoma (Grade 3 astrocytoma). Advances by UCLA neurosurgeons, neuro-oncologists and researchers continue to improve the prognosis of anaplastic astrocytoma. The UCLA Brain Tumor Program uses a multidisciplinary team approach to offer state-of-the-art treatment regimens of both standard and experimental treatments.

Symptoms

• Symptoms may include seizure, focal neurologic deficit (weakness or speech problems), headaches, personality changes, or visual loss.

Diagnosis

• Magnetic resonance imaging (MRI) is the preferred imaging technique for diagnosis.
• An actual tissue biopsy is typically required for definitive diagnosis.

Treatment

• Surgery
  • If possible, UCLA neurosurgeons attempt to remove all of the tumor visible on the MRI to relieve pressure on the surrounding brain and improve the effectiveness of certain follow-up therapies.
  • Advanced technologies such as intra-operative MRI and functional brain mapping available at UCLA may help improve surgical outcome.

MRI images of an anaplastic astrocytoma in the left frontal lobe. Prior to surgery (left image), the tumor is deep within the brain and near critical brain structures. The patient was operated on using intra-operative MRI technology (shown below). The middle image, obtained during the course of the surgery in the iMR operating room, shows residual tumor in the midline (arrow). This area of tumor was safely removed based on the information obtained using intra-operative MRI. The post-operative MRI (right) showed no visible tumor and the patient had no neurological deficits due to surgery.

• Radiation therapy
  • Six weeks of radiation therapy usually follows surgery.
  • Gamma knife (stereotactic radiosurgery) has not been shown to be effective for anaplastic astrocytoma.
  • Stereotactic radiotherapy (using the Novalis system) may be offered in certain circumstances.
• Chemotherapy
  • Standard oral chemotherapy, such as temozolomide (Temodar), is generally given during the radiation treatment with additional doses afterward.
  • Wafers loaded with chemotherapy (Gliadel) can be placed at the time of surgery. Ask your neurosurgeon and/or neuro-oncologist about this prior to surgery.
• Clinical research trials
  • The UCLA Neuro-Oncology Program offers many of the latest multicenter clinical trials available for anaplastic astrocytoma.

The Neuro-ICU cares for patients with all types of neurosurgical and neurological injuries, including stroke, brain hemorrhage, trauma and tumors. We work in close cooperation with your surgeon or medical doctor with whom you have had initial contact. Together with the surgeon or medical doctor, the Neuro-ICU attending physician and team members direct your family member's care while in the ICU. The Neuro-ICU team consists of the bedside nurses, nurse practitioners, physicians in specialty training (Fellows) and attending physicians. UCLA Neuro ICU Family Guide