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--- spinal_cord_astrocytoma_treatment [2021/01/24 20:28]
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+++ spinal_cord_astrocytoma_treatment [2021/01/24 21:29] (current)
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+====== Spinal cord astrocytoma treatment ======
+There is currently no clear [[treatment]] [[guideline]]s for the management of [[spinal cord astrocytoma]]s. Additionally there is no conclusive evidence for the surgical resection of these tumors, with some studies even demonstrating worse survival with surgery.
+However, most studies have examined patients treated prior to the routine use of magnetic resonance imaging and advanced microsurgical techniques.
+Astrocytomas of the spinal cord usually cannot be removed completely. They may be treated with surgery to obtain a diagnosis and remove as much tumor as possible, and then by radiation therapy, or with radiation therapy alone. Chemotherapy might also be an option at some point if needed.
+Somatosensory and motor evoked potential monitoring are routinely used but it is unclear if they improve outcomes. The operating microscope and bipolar cautery are essential surgical tools; the ultrasound and ultrasonic surgical aspirator are useful surgical adjuncts. Laminectomy is performed on adults while laminoplasty is favored for pediatric patients.
+In patients with spinal astrocytomas, GTR likely resulted in longer PFS when compared to STR. Adjuvant radiotherapy appears to be effective in improving survival outcomes for high-grade tumors
+((Zou Y, Sun J, Zhou Y, Bai HX, Huang X, Babu R, Landi A, Foong KS, Zhang Z, Woo
+J, Tao Y, Li X, Tang X, Xiao B, Zhang P, Yang L. Prognostic Factors and Treatment
+of Spinal Astrocytomas: A Multi-Institutional Cohort Analysis. Spine (Phila Pa
+). 2017 Nov 10. doi: 10.1097/BRS.0000000000002485. [Epub ahead of print]
+PubMed PMID: 29135884.
+)).
+----
+One-stage resection of long-level [[intramedullary astrocytoma]] and correction of complicated [[scoliosis]] might be a feasible option
+((Zhang D, Fan W, Zhao X, Massicotte EM, Fan T. Long-level intramedullary spinal cord astrocytoma complicated with spine scoliosis: Report of two cases. Int J Surg Case Rep. 2021 Jan 15;79:234-238. doi: 10.1016/j.ijscr.2021.01.035. Epub ahead of print. PMID: 33485173.)).