Astrocytoma medical therapy: Difference between revisions
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* [[Surgery]] to remove [[intraventricular tumor]]s also carries risks of complications or death. Potential complications include transient [[memory]] impairment, [[hemiparesis]], [[infection]], chronic ventriculoperitoneal shunt placement, [[stroke]], and [[death]]. | * [[Surgery]] to remove [[intraventricular tumor]]s also carries risks of complications or death. Potential complications include transient [[memory]] impairment, [[hemiparesis]], [[infection]], chronic ventriculoperitoneal shunt placement, [[stroke]], and [[death]]. | ||
* Surgery is needed for most primary [[brain]] tumors. Some [[tumor]]s may be completely removed. In cases where the [[tumor]] cannot be removed, surgery may help reduce pressure and relieve symptoms. | * Surgery is needed for most primary [[brain]] tumors. Some [[tumor]]s may be completely removed. In cases where the [[tumor]] cannot be removed, surgery may help reduce pressure and relieve symptoms. | ||
* Surgical removal remains the mainstay of treatment for Glioblastoma Multiforme, provided that unacceptable neurologic injury can be avoided. The extremely infiltrative nature of this tumor makes complete surgical removal impossible. | |||
* [[Chemotherapy]] or [[radiation therapy]] may be used for certain tumors.<ref name=tsalliance> | * [[Chemotherapy]] or [[radiation therapy]] may be used for certain tumors.<ref name=tsalliance> | ||
{{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}} | {{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}} | ||
Revision as of 19:31, 21 August 2015
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Astrocytoma Microchapters |
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Treatment |
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Astrocytoma medical therapy On the Web |
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American Roentgen Ray Society Images of Astrocytoma medical therapy |
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Risk calculators and risk factors for Astrocytoma medical therapy |
Overview
Medical Therapy
- Treatment depends on the size and type of tumor and the child's general health. The goals of treatment may be to cure the tumor, relieve symptoms, and improve brain function or the child's comfort
- Two related drugs have been shown to shrink or stabilize supependymal giant cell tumors: rapamycin and everolimus. These both belong to the mTOR inhibitor class of immunosuppressants, and are both contraindicated in patients with severe infections.
- Rapamycin showed efficacy in five cases of SEGA in TSC patients, shrinking their tumor volumes by an average of 65%. However, after the drug was stopped, the tumors regrew.
- Everolimus which has a similar structure as rapamycin, but with slightly increased bioavailability and shorter half-life, was studied in 28 patients with SEGA. There was a significant reduction in SEGA size in 75% of the patients, and a mild improvement in their seizures. Everolimus was approved for the treatment of SEGA by the US Food and Drug Administration (FDA) in October, 2010.
- The following are treatments for specific types of tumors:
- Medicines used to treat primary brain tumors in children include:
- Corticosteroids to reduce brain swelling
- Diuretics (water pills) to reduce brain swelling and pressure
- Anticonvulsants to reduce or prevent seizures
- Pain medicines
- Comfort measures, safety measures, physical therapy, occupational therapy, and other such steps may be required to improve quality of life.
- Despite decades of therapeutic research, curative intervention is still nonexistent for high grade astrocytomas; patient care ultimately focuses on palliative management.
Surgery
- A NIH Consensus Conference report in 1999 recommends that any SEGA that is growing or causing symptoms should be surgically removed. Tumors 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.
- 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.
- Surgery is needed for most primary brain tumors. Some tumors may be completely removed. In cases where the tumor cannot be removed, surgery may help reduce pressure and relieve symptoms.
- Surgical removal remains the mainstay of treatment for Glioblastoma Multiforme, provided that unacceptable neurologic injury can be avoided. The extremely infiltrative nature of this tumor makes complete surgical removal impossible.
- Chemotherapy or radiation therapy may be used for certain tumors.[1]
References
- ↑ "Supependymal Giant Cell Tumor (SGCT) or Subependymal Giant Cell Astrocytoma (SEGA)" (PDF). Tuberous Sclerosis Alliance. June 2006. Retrieved 9 September 2014.
- ↑ Campen, Cynthia J.; Porter, Brenda E. (August 2011). "Subependymal Giant Cell Astrocytoma (SEGA) Treatment Update". Current Treatment Options in Neurology. 13 (4): 380–5. doi:10.1007/s11940-011-0123-z. PMC 3130084. PMID 21465222.