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Medical management of patients with brain tumors

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Abstract

The most common medical problems in brain tumor patients include the management of seizures, peritumoral edema, medication side effects, venous thromboembolism (VTE), fatigue and cognitive dysfunction. Despite their importance, there are relatively few studies specifically addressing these issues. There is increasing evidence that brain tumor patients who have not had a seizure do not benefit from prophylactic antiepileptic medications. Patients on corticosteroids are at greater risk of Pneumocystis jerovecii pneumonia and may benefit from prophylactic therapy. There is also growing evidence suggesting that anticoagulation may be more effective than inferior vena cava IVC) filtration devices for treating VTE in brain tumor patients and the risk of hemorrhage with anticoagulation is relatively small. Low-molecular weight heparin may be more effective than coumadin. Medications such as modafinil and methylphenidate have assumed an increasing role in the treatment of fatigue, while donepezil and memantine may be helpful with memory loss.

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Acknowledgement

We gratefully acknowledge the support of the Amos Wasgatt Brain Tumor Research Fund.

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Authors and Affiliations

  1. Division of Neuro-Oncology, Department of Neurology, Brigham and Women’s Hospital and Center for Neuro-Oncology, Dana-Farber Brigham and Women’s Cancer Center, SW430D, 44 Binney Street, Boston, MA, 02115, USA

    Patrick Y. Wen, Santosh Kesari, Jan Drappatz, Debra C. Gigas & Lisa Doherty

  2. Neuro-Oncology Center, University of Virginia Health Sciences Center, Box 800432, Charlottesville, VA, 22908-0432, USA

    David Schiff

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  1. Patrick Y. Wen
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  2. David Schiff
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Correspondence to Patrick Y. Wen.

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Wen, P.Y., Schiff, D., Kesari, S. et al. Medical management of patients with brain tumors. J Neurooncol 80, 313–332 (2006). https://doi.org/10.1007/s11060-006-9193-2

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