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| ==Overview== | | ==Overview== |
| Surgery is the mainstay of treatment for certain types of astrocytoma such as [[glioblastoma multiforme]]. The feasibility of [[surgery]] depends on the stage of astrocytoma at [[diagnosis]]. | | Surgery is the mainstay of treatment for certain types of astrocytoma such as [[glioblastoma multiforme]]. The feasibility of [[surgery]] depends on the stage of astrocytoma at [[diagnosis]]. |
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| | == Indications == |
| | * Surgical intervention is the mainstay of treatment for astrocytomas. |
| | * |
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| ==Surgery== | | ==Surgery== |
| * [[Surgery]] is used to diagnose and treat childhood astrocytoma.
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| * [[Surgery]] is needed for most primary [[brain tumor]]s. Some [[tumor]]s may be completely removed. In cases where the [[tumor]] cannot be removed, [[surgery]] may help reduce pressure and relieve [[symptom]]s.
| | == Contraindications == |
| * A NIH Consensus Conference report in 1999 recommends that any [[subependymal giant cell astrocytoma]] that is growing or causing symptoms should be surgically removed. [[Tumor]]s are also removed in cases where a patient is suffering from a high [[seizure]] burden. If a [[tumor]] is rapidly growing or causing symptoms of [[hydrocephalus]], deferring [[surgery]] may lead to [[vision]] loss, need for ventricular shunt, and ultimately death. Total removal of the [[tumor]] is curative.
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| * [[Surgery]] to remove intraventricular tumors also carries risks of complications or death. Potential complications include transient [[memory]] impairment, [[hemiparesis]], [[infection]], chronic ventriculoperitoneal shunt placement, [[stroke]], and death.
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| * Even if the doctor removes all the [[cancer]] that can be seen at the time of the [[surgery]], some patients may be given [[chemotherapy]] or [[radiation therapy]] after [[surgery]] to kill any [[cancer cell]]s that remain. <ref name=tsalliance>
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| {{cite web| title=Supependymal Giant Cell Tumor (SGCT) or Subependymal Giant Cell Astrocytoma (SEGA)| url=http://www.tsalliance.org/documents/Subependymal%20Giant%20Cell%20Tumor%20SGCT%20or%20Subependymal%20Giant%20Cell%20Astrocytoma%20SEGA.pdf| publisher=Tuberous Sclerosis Alliance| accessdate=9 September 2014| date=June 2006}}
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| </ref><ref name=campen2011>
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| {{cite journal|last1=Campen|first1=Cynthia J.|last2=Porter|first2=Brenda E.|title=Subependymal Giant Cell Astrocytoma (SEGA) Treatment Update|journal=Current Treatment Options in Neurology|date=August 2011|volume=13|issue=4|pages=380–5|doi=10.1007/s11940-011-0123-z|pmid=21465222|pmc=3130084}}
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| </ref>
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| * An [[MRI]] is done after [[surgery]] to see if there is tumor remaining. If the tumor was completely removed by surgery, more treatment may not be needed and the child is closely watched to see if signs or symptoms appear or change. This is called observation.
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| * If there is [[tumor]] remaining after [[surgery]], treatment may include the following:
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| ** Observation
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| ** A second [[surgery]] to remove the [[tumor]]
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| ** [[Radiation therapy]], which may include conformal [[radiation therapy]], intensity-modulated [[radiation therapy]], or stereotactic [[radiation therapy]], when the [[tumor]] begins to grow again
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| ** Combination [[chemotherapy]] with or without [[radiation therapy]]
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| ** A clinical trial of targeted therapy with selumetinib
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| ==References== | | ==References== |