Spinal cord astrocytoma treatment

There is currently no clear treatment guidelines for the management of spinal cord astrocytomas. 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 1).

One-stage resection of long-level intramedullary astrocytoma and correction of complicated scoliosis might be a feasible option 2).

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 1976). 2017 Nov 10. doi: 10.1097/BRS.0000000000002485. [Epub ahead of print] PubMed PMID: 29135884.
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.
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  • Last modified: 2021/01/24 21:29
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