Zusammenfassung
Rückenmarkgliome – spinale Ependymome und Astrozytome – sind mit einem Anteil von ca. 3% an allen primären ZNS-Tumoren selten. Die meisten spinalen Gliome sind niedriggradig. Diffuse und maligne Astrozytome wachsen infiltrativ, was Resektabilität und operative Sicherheit deutlich einschränkt. Pilozytische Astrozytome und Ependymome sind dagegen gut operable Tumore mit einer guten lokalen Tumorkontrolle nach alleiniger Resektion. Das mittlere progressionsfreie Überleben nach Komplettresektion spinaler Gliome beträgt ca. 7 Jahre. Höhergradige Astrozytome haben eine schlechtere Prognose mit 17 Monaten medianer Überlebenszeit bei anaplastischen Astrozytomen und 9–10 Monaten bei Glioblastomen. Eine adjuvante Strahlentherapie nach Resektion eines Grad-I–II-Ependymoms oder eines pilozytischen Astrozytoms wird nicht empfohlen. Bei Rezidiven, disseminierten und anaplastischen Ependymomen sowie bei spinalen Astrozytomen Grad II–IV sollte eine fraktionierte Strahlentherapie erfolgen.
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Meyer, B., Wostrack, M. (2018). Rückenmarkgliome. In: Simon, M. (eds) Gliomchirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-48694-8_22
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