低度恶性星形细胞瘤和少质胶质细胞瘤 治疗指南

low- gradeastrocytomas and oligodendrogliomas

低度恶性星形细胞瘤和少质胶质细胞瘤 治疗指南

 

recommendations

1. in patients witha low-grade glioma and controlled epilepsy as the single symptom, surgery maybe deferred until clinical or radiological progression. 上海东方医院神经外科魏社鹏

患有低度恶性胶质瘤，可控的癫痫发作是唯一症状的病人，手术可以被推迟到当临床或者影像学上发现有进展的时候。

2. wheneverpossible, maximal surgical resection should be attempted in patients who haveincreased intracranial pressure, neurological deficits, uncontrollableseizures, or in those who have clinical or radiological progression.

无论何时，那些有颅内压增高的，神经系统功能缺损的，不能控制的癫痫发作的，或者临床和影像学上有进展的病人，都应该接受最大限度的肿瘤切除术。

3. for patients whoundergo a complete surgical resection, radiotherapy may be deferred untilclinical or radiological disease progression; in such cases, regular follow-upis essential.

对于那些接受过全部切除的病人，放疗可以推迟到当临床或者影像学上出现进展的时候，对于此类病人，规律性的随访是最重要。

4. post-surgicalradiotherapy may be administered to patients who undergo an incomplete surgicalresection or biopsy only. when radiotherapy is indicated, the dose should bebetween 45 and 54 gy, delivered in 1.8 to 2.0 gy fractions.

术后放疗应当被给予那些不全切除的病人或者仅仅做过活检的病人。准备给予放疗的时候，剂量应当被控制在45-54gy，每次1.8-2.0gy。

5. chemotherapyshould not be routinely added to radiation therapy for first line treatmentfollowing surgery, since the combination shows limited benefit in comparison toradiotherapy alone following surgery, and may increase toxicity.

 放疗之后，化疗并不作为常规。因为和单纯放疗比起来，放化疗联合的益处有限，并且还可能增加毒性。

6. at diseaseprogression or recurrence, the standard treatment is repeat surgical resectionfollowed by radiotherapy. temozolomide may also be considered for the treatmentof disease recurrence, particularly for patients that harbour a combinedchromosome 1p/19q loss of heterozygosity.

对于进展的或复发的肿瘤，标准的治疗方案是重复手术继而辅以放疗。替莫唑胺可以考虑用于复发肿瘤的治疗，尤其是那些有1p/19q同时缺失的病人。

7. for high riskpatients, inclusion in a clinical trial is recommended. in the absence of aclinical trial adjuvant chemotherapy and radiation therapy may be considered onan individual basis.

对于高风险的低度恶性胶质瘤病人，给予合适的临床试验是可行的。没有临床试验时，辅助的化疗和放疗对于个体病人是可以考虑的。