Možnosti terapie pacientů s meningeomem grade III

Title in English Options for Therapy of Patients with Hemangiomas Grade III


Year of publication 2016
Type Article in Periodical
Magazine / Source Česká a slovenská neurologie a neurochirurgie
MU Faculty or unit

Faculty of Medicine

Field Neurology, neurosurgery, neurosciences
Keywords meningioma WHO grade III; diagnostics; therapy; surveillance
Description Meningioma grade Ill is one of rare tumors of the central nervous system. Unlike benign forms, grade III meningiomas are known for rapid aggressive growth and poor prognosis. Compared to benign forms, they tend to grow more intraaxially, infiltrating brain tissue. Resection, even though radical, must be followed by immediate adjuvant radiotherapy that allows better local control, especially in partially resected tumors. The disease continues to have poor prognosis and short survival time irrespective of the comprehensive treatment of this quite infrequent variant of the disease. Adjuvant radiotherapy could be combined with or followed by chemotherapy. Newly available data are to shed new light on this topic. Hormonal therapy and some aspects of molecular biology have been suggested as promising methods to improve patient prognosis. These new methods as well as stereotactic radiosurgery could provide suitable options for the treatment of malignant meningioma recurrence. The authors present case series of six patients with meningioma grade Ill. The group was analysed in terms of the diagnosis, extent of dissection, size of the residuum before radiation therapy as well as in terms of follow-up and median survival. Two patients underwent radical resection (Simpson 1), while four remaining underwent Simpson 3 resection. Afterwards, all patients underwent radiotherapy. Recurrence was managed individually. Therapy varied from reoperation through gamma knife treatment to palliation. Median survival was 18 +/- 7 months. Any therapeutic approach should be as radical as possible while minimizing a risk of neurological deficit.

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