Paediatric gliomas: diagnosis, molecular biology and management
| Autor: | Ploutarchos Karydakis, Alexandros Blionas, Marios Themistocleous, Dimitrios Giakoumettis, Alexia Klonou, Eleftherios Neromyliotis |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
In vivo magnetic resonance spectroscopy
Chemotherapy medicine.medical_specialty business.industry medicine.medical_treatment General Medicine medicine.disease Radiosurgery Radiation therapy 03 medical and health sciences 0302 clinical medicine Residual Tumours 030220 oncology & carcinogenesis Glioma medicine Radiology Radiation treatment planning business Review Article on Molecular Oncology 030217 neurology & neurosurgery Chemoradiotherapy |
| Popis: | Paediatric gliomas represent the most common brain tumour in children. Early diagnosis and treatment greatly improve survival. Histological grade is the most significant classification system affecting treatment planning and prognosis. Paediatric gliomas depend on pathways and genes responsible for mitotic activity and cell proliferation as well as angiogenesis (MAPK, VEGF, EFGR pathways). Symptoms such as focal neurologic deficit or seizures can facilitate diagnosis, but they are not always present and therefore diagnosis is occasionally delayed. Imaging has adequate diagnostic accuracy (surpassing 90%), and novel imaging techniques such as MR spectroscopy and PET increase only slightly this percentage. Low grade gliomas (LGG) can be approached conservatively but most authors suggest surgical excision. High grade gliomas (HGG) are always operated with exception of specific contradictions including butterfly or extensive dominant hemisphere gliomas. Surgical excision is universally followed by radiotherapy and chemotherapy, which slightly increase survival. Inoperable cases can be managed with or without radiosurgery depending on location and size, with adjunctive use of radiotherapy and chemotherapy. Surgical excision must be aggressive and gross total resection (GTR) should be attempted, if possible, since it can triple survival. Radiosurgery is effective on smaller tumours of |
| Databáze: | OpenAIRE |
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