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Treatment for brain tumor does not always follow recommendations

nt) and antiepileptic medications (n = 497; 88 percent), but few received antidepressants (n = 38; 8 percent) or prophylactic heparin (n=42; 7 percent). Most received radiation therapy (n = 479; 87 percent) in addition to other therapy, but fewer received chemotherapy (n = 300; 54 percent). Practice patterns varied significantly between academic and community settings.

"We present patterns of care for a large group of patients with newly diagnosed malignant glioma treated in the modern era. Some common practice patterns are in keeping with published literature (e.g., use of radiation therapy), some contradict published guidelines (e.g., frequent prophylactic antiepileptic drug administration) or may conflict with published literature (e.g., relatively infrequent use of chemotherapy), and still others point out areas for further investigation in this population, including heparin prophylaxis for venous thromboembolism, antidepressant medication, corticosteroid dosing, and use of surgical adjuncts. Variations in patterns of care were associated with differences in survival; establishing further practice guidelines may help reduce this variability. One of the major benefits of the GO Project is that it provides a broad historical cohort that can be used as a comparison for future prospective studies," the authors conclude.

(JAMA. 2005;293:557-564. Available post-embargo at JAMA.com)

Editor's Note: For funding and financial disclosure information, please see the JAMA article.

Editorial: Malignant Gliomas in 2005 - Where to GO From Here?

In an accompanying editorial, Paul Graham Fisher, M.D., of Stanford University, Stanford, Calif., and Patricia A. Buffler, Ph.D., of the University of California, Berkeley discuss the findings by Chang et al.

"Where should treatment of gliomas go from here? Neuro-oncology requires a major paradigm shift and substantial changes in treatment and rese
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Contact: Carol Hyman
415-476-2557
JAMA and Archives Journals
1-Feb-2005


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