title: Management of Patients with Primary Intramedullary Spinal Cord Glioblastoma.
abstract: BACKGROUND
  Primary intramedullary spinal cord glioblastomas are very rare tumors of the spinal cord. They imply a very poor prognosis because complete surgical resection is not possible as the result of the infiltrative growth of these tumors. The aim of this study is to present our data achieved with an aggressive multimodality treatment.
  
  
  METHODS
  We retrospectively reviewed our clinical database. All patients with histologically proven intramedullary spinal cord glioblastoma treated in our department were included in this study.
  
  
  RESULTS
  Four patients with intramedullary spinal cord glioblastoma were identified between 2006 and 2015, all of whom were female. Mean age at the time of surgery was 33.5 years (range 14-50 years). Tumors were located in the cervical region in 2 patients and in the thoracic region in 2 patients. All 4 patients underwent microsurgical biopsy of the tumor. After surgery, all patients received radiation and temozolomide treatment. One patient underwent additional therapy with Bevacizumab, another patient received Rapamycin and Sunitinib, and the third patient received Chlorethyl-cyclohexyl-nitroso-urea and Etoposide as additional therapy after tumor regrowth. Tumor progression occurred in a mean time of 18.2 months (6-32 months). In this series, all patients died as the result of progression of the malignancy; median survival after diagnosis was 32.5 months.
  
  
  CONCLUSIONS
  The surgical outcome of intramedullary spinal cord glioblastoma still remains poor. Severe disability and amelioration of the neurologic status lead to reduced quality of life; however, an aggressive multimodal and interdisciplinary treatment for the disease may be associated with longer survival.
authors: Department of Neurosurgery, University Hospital Frankfurt, Goethe-University, Frankfurt, Germany. Electronic address: bedjan.behmanesh@gmail.com.
authors: Bedjan
authors: B
authors: Behmanesh
authors: Department of Neurosurgery, University Hospital Frankfurt, Goethe-University, Frankfurt, Germany.
authors: Matthias
authors: M
authors: Setzer
authors: Department of Neurosurgery, University Hospital Frankfurt, Goethe-University, Frankfurt, Germany.
authors: Juergen
authors: J
authors: Konczalla
authors: Department of Neuropathology, University Hospital Frankfurt, Goethe-University, Frankfurt, Germany.
authors: Patrick
authors: P
authors: Harter
authors: Department of Neurosurgery, University Hospital Frankfurt, Goethe-University, Frankfurt, Germany.
authors: Johanna
authors: J
authors: Quick-Weller
authors: Department of Neurosurgery, University Hospital Frankfurt, Goethe-University, Frankfurt, Germany.
authors: Lioba
authors: L
authors: Imoehl
authors: Department of Neurosurgery, University Hospital Frankfurt, Goethe-University, Frankfurt, Germany.
authors: Kea
authors: K
authors: Franz
authors: Department of Neurosurgery, University Hospital Frankfurt, Goethe-University, Frankfurt, Germany.
authors: Florian
authors: F
authors: Gessler
authors: Department of Neurosurgery, University Hospital Frankfurt, Goethe-University, Frankfurt, Germany.
authors: Volker
authors: V
authors: Seifert
authors: Department of Neurosurgery, University Hospital Frankfurt, Goethe-University, Frankfurt, Germany.
authors: Gerhard
authors: G
authors: Marquardt
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D005909:Glioblastoma / Q000000981:diagnostic imaging* / Q000601:surgery* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000639:trends; D008875:Middle Aged; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000175:diagnosis* / Q000601:surgery* / Q000628:therapy
chemical_list: D000970:Antineoplastic Agents
keywords: Intramedullary glioblastoma; Multimodal therapy; Radiation; Spinal cord; Surgery