Astrotsitomy nizkoy stepeni zlokachestvennosti polushariy bol'shogo mozga

Abstract


Астроцитомы являются первичными новообразованиями, состоящими из поддерживающих клеток центральной нервной системы и, следовательно, относящимися к опухолям глиальной ткани. Астроцитомы низкой степени злокачественности (АНЗ) - это медленно растущие новообразования, с высокой степенью клеточной дифференцировки, диффузно инфильтрирующие прилежащее мозговое вещество. Данная патология имеет большое клиническое и социальное значение, так как эти опухоли встречаются наиболее часто среди внутричерепных новообразований, поражают людей молодого возраста и в то же время представляют собой наиболее доброкачественную форму среди внутримозговых опухолей, которые, как известно, крайне редко могут быть удалены радикально. Тактика, позволяющая сохранить высокое качество жизни таких пациентов с максимально благоприятным прогнозом на ближайшие годы, до сих пор обсуждаема. Значимость проблемы возрастает наряду с совершенствованием точности нейровизуальных методов диагностики, прежде всего компьютерной (КТ) и магнитно-резонансной (МРТ) томографий головного мозга. Использование дифференциального подхода к определению этапности и тактики лечения таких больных предусматривает возможность улучшения и качества, и продолжительности их жизни.

About the authors

V A Aleshin

V B Karakhan

References

  1. Арутюнов А.И. Принципы хирургического лечения глиом больших полушарий головного мозга. Опухоли головного мозга. М., 1975; с. 7-11.
  2. Васин Н.Я. Хирургическое лечение внутримозговых нейроэктодермальных опухолей височной доли головного мозга. Дис.. д - ра мед. наук. М., 1970.
  3. Голанов А.В. Дифференцированный подход к лечению глиом низкой степени злокачественности. Дис.. канд. мед. наук. М., 1992.
  4. Земская А.Г., Лещинский Б.И. Опухоли головного мозга астроцитарного ряда. Л., 1987.
  5. Качков И.А. Предоперационное окрашивание опухолей мозга. Опухоли головного мозга. М., 1975; с. 197-205.
  6. Корейша Л.А., Виноградова И.Н. Хирургическое лечение нейроэктодермальных опухолей головного мозга. Руководство по хирургии. Т. III. Нейрохирургия, кн.2. М., 1968; с. 528-77.
  7. Меликян А.Г., Голанов А.В., Касумова С.Ю. и др. КТ-стереотаксическая биопсия опухолей головного мозга. Вопр. нейрохирургии. 1992; 5: 17-22.
  8. Atlas S.W, Howard R.S, Maldjian J et al. Functional magnetic resonance imaging of regional brain activity in patients with intracerebral glioma: findings and implications for clinical management. Neurosurgery 1996; 38: 329-37.
  9. Bampoe J, Bernstein M. The role of surgery in low - grade gliomas. J Neurooncology 1999; 42: 259-69.
  10. Bauman G, Lote K, Larson D et al. Pretreatment factors predict overall survival for patients with low - grade glioma: A recursive partitioning analysis. Int J Radiat Oncol Biol Phys 1999; 45: 923-9.
  11. Berger M.S, Deliganis A.V, Dobbins J, Keles G.E. The effect of extent of resection on recurrence in patients with low - grade cerebral hemisphere gliomas. Cancer 1994; 74: 1784-91.
  12. Berger M.S, Rostomily R.C. Low - grade gliomas: Functional mapping resection strategies, extent of resection, and outcome. J Neurooncol 1997; 34: 85-101.
  13. Burger P.C, Scheithauer B.W. Tumors of the Central Nervous System. Armed Forces Institute of Pathology, Washington DC, 1994.
  14. Cairncross J.G. Understanding low - grade glioma. Neurology 2000; 54: 1402-3.
  15. Chamberlain M.C, Murovic J.A, Levin V.A. Absence of contrast enhancement on CT brain scans of patients with supratentorial malignant gliomas. Neurology 1988; 64: 581-7.
  16. Disabato J.A, Handler M.H, Stain J.D, Fleitz J.M, Foreman N.K. Successful use of inracavitary bleomycin for low grade astrocytoma tumor cyst. Pediatr Neurosurg 1999; 31: 246-50.
  17. Eyre H.J, Crowley J.J, Townsend J.J et al. A randomized trial of radiotherapy versus radiotherapy plus CCNU for incompletely resected low - grade gliomas: A Southest Oncology Group study. J Neurosurg 1993; 78: 909-14.
  18. Fadul C, Wood J, Thaler H, Galicich J, Patterson Jr R.H, Posner J.B. Morbidity and mortality of craniotomy for excision of supratentorial gliomas. Neurology 1988; 38: 1374-9.
  19. Forsyth P.A, Kelly P.J, Cascino T.I et al. Radiation necrosis or glioma recurrence: is computer assisted stereotactic biopsy useful? J Neurosurg 1995; 82: 436-44.
  20. Francavilla T.L, Miletich R.S, Di Chiro G et al. Positron emission tomography in the detection of malignant degeneration of low - grade glioma. Neurosurgery 1989; 24: 1-5.
  21. Guthrie B.L, Laws E.R. Supratentorial low - grade gliomas. Neurosurg Clin North Am 1990; 1: 37-48.
  22. Hilton D.A, Love S, Barber R et al. Accumulation of p53 and Ki-67 expression do not predict survival in patients with fibrillary astrocytomas or the response of these tumors to radiotherapy. Neurosurgery 1998; 42: 724-9.
  23. Holt R.M, Maravilla K.R. Supratentorial gliomas: Imaging. In: Wilkins R.H, Rengachary S.S (eds). Neurosurgery. Mc Grow-Hill, New-York, 1996; p. 881-9.
  24. Ito S, Chandler K.L, Prados M.D et al. Proliferative potential and prognostic evaluation of low - grade astrocytomas. J Neurooncol 1994; 19: 1-9.
  25. Janny P, Cure H, Mohr M et al. Low grade supratentorial astrocytomas: Management and prognostic factors. Cancer 1994; 73: 1937-45.
  26. Karim A.B, Cornu P, Bleehen N et al. Immediate postoperative radiotherapy in low - grade glioma improves progression free survival, but not overall survival: Preliminary results of EORTC/MRC randomized phase III study. Proc Am Soc Clin Oncol 1998; 17: 400a.
  27. Karim A.B, Maat B, Hatlevoll R et al. A randomized trial on dose - response in radiation therapy of low - grade cerebral glioma: EORTC Study 22844. Int J Radiat Oncol Biol Phys 1996; 36: 549-56.
  28. Kaye A.H, Walker D.G. Low grade astrocytomas: Controversies in management. J Clin Neurosc 2000; 7: 475-83.
  29. Kelly P.J. Computed tomography and histologic limits in glial neoplasms: tumor types and selection for volumetric resection. Surg Neurol 1993; 39: 458-65.
  30. Kiebert G.M, Curran D, Aaronson N.K et al. Quality of life after radiation therapy of cerebral low - grade gliomas of the adult: Results of randomized phase III trial on dose response (EORTC trial 22844). EORTC Radiotherapy Cooperative Group. Eur J Cancer 1998; 34: 1902-9.
  31. Kleihues P, Divas R.L, Ohgaki H et al. Diffuse astrocytoma. In: Kleihues P, Cavenee W.K (eds). Pathology and Genetics of Tumors of the Nervous System. IARC Press, Lyon 2000; 22-8.
  32. Kleihues P, Divas R.L, Ohgaki H, Cavenee W.K. Low - grade diffuse astrocytomas. In: Kleihues P, Cavenee W.K (eds). Tumors of the Nervous System: Pathology and Genetics. International Agency for Research on Cancer, Lyon 1997; p. 10-4.
  33. Kondziolka D, Lunsford L.D, Martinez A.J. Unreliability of contemporary neurodiagnostic imaging in evaluation suspected adult supratentorial (low - grade) astrocytomas. J Neurosurg 1993; 79: 533-6.
  34. Kondziolka D, Lunsford L.D. The role of stereotactic biopsy in the management of gliomas. J Neurooncol 1999; 42: 205-13.
  35. Krouwer H.G, Davis R.L, Silver P, Prados M. Gemistocytic astrocytomas: A reappraisal. J Neurosurg 1991; 74: 399-406.
  36. Lang F.F, Miller D.C, Koslow M, Newcomb E.W. Pathways leading to glioblastoma multiforme: A molecular analysis of genetic alterations in 65 astrocytic tumors. J Neurosurg 1994; 81: 427-36.
  37. Laws Jr.E.R, Taylor W.F, Clifton M.B, Okazaki H. Neurosurgical management of low - grade astrocytoma of the cerebral hemispheres. J Neurosurg 1984; 61: 665-73.
  38. Leibel S.A, Sheiline G.E, Wara W.M et al. The role of radiation therapy in the treatment of astrocytomas. Cancer 1975; 35: 1551-7.
  39. Leighton C, Fisher B, Bauman G et al. Supratentorial low - grade glioma in adults: An analysis of prognostic factors and timing of radiation. J Clin Oncol 1997; 15: 1294-301.
  40. Louis D.N. The p53 gene and protein in human brain tumors. J Neuropatol Exp Neurol 1994; 53: 11-21.
  41. Lunsford L.D, Somaza S, Kondziolka D, Flickinger J.C. Survival after stereotactic biopsy and irradiation of cerebral nonanaplastic, nonpilocytic astrocytoma. J Neurosurg 1995; 82: 523-9.
  42. Mansur D.B, Hekmatpanah J, Wollman R et al. Low grade gliomas treated with adjuvant radiation therapy in the modern imaging era. Am J Clin Oncol 2000; 23: 222-6.
  43. Mc Cormack B.M, Miller D.C, Budzilovich G.N et al. Treatment and survival of low - grade astrocytomas in adults 1977-1988. Neurosurgery 1992; 31: 636-42.
  44. Morantz R.A. Low - grade astrocytomas. In: Wilkins R.H, Rengachary S.S (eds). Neurosurgery. Mc Graw-Hill, New York, 1996; 789-98.
  45. Nakamura M, Konishi N, Tsunoda S et al. Analysis of prognostic and survival factors related to treatment of low - grade astrocytomas in adults. Oncology 2000; 58: 108-16.
  46. Nazzaro J.M, Neuwell E.A. The role of surgery in the management of supratentorial intermediate and high - grade astrocytomas in adults. J Neurosurg 1990; 73: 331-4.
  47. Nicolato A, Gerosa M.A, Fina P et al. Prognostic factors in low - grade supratentorial astrocytomas: a uni - and multivariate statistical analysis in 76 surgically treated adult patients. Surg Neurol 1995; 44: 208-23.
  48. North C.A, North R.B, Epstein J.A et al. Low - grade astrocytomas: Survival and quality of life after radiaton therapy. Cancer 1990; 66: 6-14.
  49. Olson J.D, Riedel E, De Angelis L.M. Long term outcome of low - grade oligodendroglioma and mixed glioma. Neurology 2000; 54: 1442-8.
  50. Philippon J.H, Clemenceau S.H, Fauchon F.H, Foncin J.F. Supratentorial low - grade astrocytomas in adults. Neurosurgery 1993; 32: 554-9.
  51. Piepmeier J, Christopher S, Spencer D et al. Variations in the natural history and survival of patients with supratentorial low - grade astrocytomas. Neurosurgery 1996; 38: 872-8.
  52. Prayson R.A, Estes M.L. Protoplasmic astrocytoma: A clinicopathologic study of 16 tumors. Am J Clin Pathol 1995; 103: 705-9.
  53. Radhakrishnan K, Bohnen N.I, Kurland L.T. Epidemiology of brain tumors. In: Morantz R.A, Walsh J (eds). Brain Tumors: A Comprehensive Text. Marcel Dekker, New York, 1993.
  54. Raian B, Pickuth D, Ashley S et al. The management of histologically unverified presumed cerebral gliomas with radiotherapy. Int J Radiat Oncol Biol Phys 1994; 28: 405-13.
  55. Rasheed B.K, Mc Lendon R.E, Herndon J.E et al. Alterations of the p53 gene in human gliomas. Cancer Res 1994; 54: 1324-30.
  56. Reifenberger J, Ring G.U, Gies U et al. Analysis of p53 mutation and epidermal growth factor receptor amplification in recurrent gliomas with malignant progression. J Neuropatol Exp Neurol 1996; 55: 822-31.
  57. Russell D, Rubinstein L.J. Pathology of Tumors of the Nervous System, 5th edn. Williams & Wilkins, Baltimore, 1989.
  58. Scanlon P.W, Taylor W.F. Radiotherapy of intracranial astrocytomas: Analysis of 417 cases treated from 1960 through 1969. Neurosurgery 1979; 5: 301-8.
  59. Schiffer D, Cavalla P, Chio A et al. Proliferative activity and prognosis of low - grade astrocytomas. J Neurooncol 1997; 34: 31-5.
  60. Schultz C.J, Geard C.R. Radioresponse of human astrocytic tumors across grade as a function of acute and chronic irradiation. Int J Radiat Oncol Biol Phys 1990; 19: 1397-403.
  61. Shafqat S, Hedley Whyte E.T, Henson J.W. Age - dependent rate of anaplastic transformation in low - grade astrocytomas. Neurology 1999; 52: 867-9.
  62. Shaw E.G, Arussell A, Scheithauer B et al. A prospective randomized trial of low - versus high - dose radiation therapy in adults with supratentorial low - grade glioma: initial report of a NCCTG-RTOG-ECOG study. Proc Am Soc Clin Oncol 1998; 17: 401a.
  63. Sheline G.E. The role of radiation therapy in the treatment of low - grade gliomas. Clin Neurosurg 1986; 33: 563-74.
  64. Shibamoto Y, Kitakabu Y, Takahashi M et al. Supratentorial low grade astrocytoma: correlation of computed tomography findings with effect of radiation therapy and prognostic variables. Cancer 1992; 72: 190-5.
  65. Shibamoto Y, Yamashita J, Takahashi M et al. Supratentorial malignant glioma: An analysis of radiation therapy in 178 cases. Radiother Oncol 1990; 18: 9-17.
  66. Sidransky D, Mikkelsen T, Schwechheimer K et al. Clonal expansion of p53 mutant cells is associated with astrocytomas. Nature1992; 355: 846-7.
  67. Soffieti R, Chio A, Giordana M.T et al. Prognostic factors in well - differentiated cerebral astrocytomas in the adult. Neurosurgery 1989; 24: 686-92.
  68. Struikmans H, Rutgers D.H, Jansen G.H et al. Prognostic relevance of cell proliferation markers and DNA-ploidy in gliomas. Acta Neurochir (Wien) 1998; 140: 140-7.
  69. van Veelen M.L, Avezaat C.J, Kros J.M et al. Supratentorial low grade astrocytoma: Prognostic factors dedifferentiation, and the issue of early versus late surgery. J Neurol Neurosurg Psychiatry 1993; 64: 581-7.
  70. Vecht C.J. Effect of age on treatment decisions in low - grade glioma. J Neurol Neurosurg Psychiatry 1993; 56: 1259-64.
  71. Vertosick Jr.F.T, Selker R.G, Arena V.C. Survival of patients with well - differentidted astrocytomas diagnosed in the era of computed tomography. Neurosurgery 1991; 28: 496-501.
  72. Walker D.G, Lavin M. Molecular genetics of astrocytomas: A review. J Clin Neurosci 1997; 3: 19-26.
  73. Watne K, Hannisdal E, Nome O et al. Combined intra - arterial chemotherapy followed by radiation in astrocytomas. J Neurooncol 1992; 14: 73-80.
  74. Watanabe K, Sato K, Biernat W et al. Incidence and timing of p53 mutations during astrocytomas progression in patients with multiple biopsies. Clin Cancer Res 1997; 3: 523-30.
  75. Whitton A.C, Bloom H.J. Low grade glioma of the cerebral gemispheres in adults: A retrospective analysys of 88 cases. Int J Radiat Oncol Biol Phys 1990; 18: 783-6.
  76. Wilden J.N, Kelly P.J. CT computerized stereotactic biopsy for low density CT lesions presenting with epilepsy. J Neurol Neurosurg Psychiatry 1987; 50: 1302-5.
  77. Worthington C, Tyler J.L, Villemure J.G. Stereotaxic biopsy and positron emission tomography correlation of cerebral gliomas. Surg Neurol 1987; 27: 87-92.

Statistics

Views

Abstract - 22

Cited-By


Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies