Smits A, Ribom D
Akademiska sjukhuset, Uppsala.
Lakartidningen. 2000 Sep 6;97(36):3886-90.
Management of patients with low-grade gliomas remains a challenge. Controversies exist regarding the value of surgery and radiotherapy as well as the right timing of these treatments with respect to disease course. Several factors have been shown to have a positive correlation with better outcome, involving tumor size and localization, age and clinical condition of the patient on presentation, and epileptic seizures as a single symptom. The absence of contrast enhancement on CT-scans is also a favorable prognostic factor. Taking into account the results of these studies as well as our own experience, we suggest some strategies for the management of patients with low-grade gliomas. The importance of identifying "high-risk" patients by systematic clinical and radiological follow-up is discussed.
低级别胶质瘤患者的管理仍然是一项挑战。关于手术和放疗的价值以及这些治疗相对于疾病进程的正确时机存在争议。已表明有几个因素与较好的预后呈正相关,包括肿瘤大小和位置、患者就诊时的年龄和临床状况以及癫痫发作这一单一症状。CT扫描上无强化也是一个有利的预后因素。考虑到这些研究结果以及我们自己的经验,我们提出了一些低级别胶质瘤患者的管理策略。讨论了通过系统的临床和影像学随访识别“高危”患者的重要性。