低级别胶质瘤.doc

Glioma patients group:two four nine one five eight seven seven eight 胶质瘤病友群：249158778 1. In patients with low grade glioma and controlled epilepsy as the single symptom, surgery may be deferred until clinical or radiological progression. (Level of Evidence 4- Recommendation grade C) 当可控的癫痫作为唯一症状的低度恶性胶质瘤患者，在没有出现临床上或者影像上的进展的时候，手术可以推迟。 上海东方医院神经外科魏社鹏 In one retrospective study by van Veelen et al, it was shown that in patients with controlled seizures as the single symptom, the prognosis is not influenced by the timing of the surgery. It could be, therefore, safe to defer surgery until clinical or radiological progression in patients with controlled epilepsy only. Veelen等一项回顾性研究发现，以癫痫发作为单一症状的胶质瘤病人，其预后并没有被手术的时机所影响，故建议在病人的临床症状和影像学结果没有出现进展之前，尽可能的推迟手术也是很安全的。 In 1994 Berger et al analyzed the effect of extent of resection on recurrence in patients with low grade gliomas. They found that for tumours greater than 10 cm3 a greater percent of resection and a smaller volume of residual disease convey a significant advantage in terms of recurrence, compared to those that had a less aggressive resection or biopsy. For tumours smaller than 10 cm3 no recurrence was detected over 3 to 4 years, regardless of percent of resection. 1994年，Berger等发现那些体积大于10立方厘米的肿瘤，术中切除越多，则复发越迟，而那些体积小于10立方厘米的肿瘤，切除程度和复发则没有联系。 2. In patients with increased intracranial pressure, neurological deficits, uncontrollable seizures, or in those who have clinical or radiological progression, maximal resection, when safe, should be attempted. (Level of Evidence 3- Recommendation grade B) 对于有颅内压增高症状的病人，以及有神经功能缺损，未控制的癫痫，或者临床或者影像上出现进展的病人，在安全的前提下，尽可能做根治性的切除。 3. Postsurgical radiation therapy may be deferred until clinical or radiological progression. When Radiation therapy is indicated, the dose should be between 45 and 54 Gy. (Level of Evidence 1- Recommendation grade A) 术后放疗可以被推迟，直到出现临床或者影像上的进展。当施行放疗时，剂量应当在45-54Gy之间。 A clinical trial (EORTC 22845) performed in 2002 compared immediate RT given after sur