Zusammenfassung
Bei PatientInnen mit rezidivierten malignen Gliomen gibt es auch für das neurochirurgische Vorgehen keine akkordierten Standards. Zur Entscheidungsfindung hat stets der mögliche Benefit für den Patienten/die Patientin im Vordergrund zu stehen. Oft ist unter der Ausnützung der modernen Diagnosemethoden und der optimierten Resektion mit Hilfe von Neuronavigation und Anwendung von 5-Ala in vivo Fluoreszenz eine erneute Tumorresektion oder Verkleinerung möglich, die es erlaubt, Symptomverbesserung und eine längere Überlebenszeit zu erreichen.
Summary
There is currently no standard for neurosurgical interventions in patients with recurrent high grade gliomas. An individualized approach is recommended as well for decision-making as for planning an intervention with resection of the outmost possible amount of tumor tissue while preserving neurological function and thus quality of life. Recent technical developments of imaging and of neuronavigation and visualization of tumor tissue with in vivo fluorescence with 5-Ala have proved helpful in improving symptoms and prolonging survival times also for patients with recurrent malignant gliomas.
Article PDF
Avoid common mistakes on your manuscript.
Literature
Barbagallo GM, Jenkinson MD, Brodbelt AR. 'Recurrent' glioblastoma multiforme, when should we reoperate? Br J Neurosurg, 22: 452–455, 2008
Guyotat J, Signorelli F, Frappaz D, et al. Is reoperation for recurrence of glioblastoma justified? Oncol Rep, 7: 899–904, 2000
Pinsker M, Lumenta C. Experiences with reoperation on recurrent glioblastoma multiforme. Zentralbl Neurochir, 62: 43–47, 2001
Mandl ES, Dirven CM, Buis DR, et al. Repeated surgery for glioblastoma multiforme: only in combination with other salvage therapy. Surg Neurol, 69: 506–509, 2008; discussion 509
Stummer W, Stocker S, Novotny A, et al. In vitro and in vivo porphyrin accumulation by C6 glioma cells after exposure to 5-aminolevulinic acid. J Photochem Photobiol B, 45: 160–169, 1998
Stummer W, Pichlmeier U, Meinel T, et al. Fluorescence-guided surgery with 5-aminolevulinic acid for resection of malignant glioma: a randomised controlled multicentre phase III trial. Lancet Oncol, 7: 392–401, 2006
Nabavi A, Thurm H, Zountsas B, et al.; 5-ALA Recurrent Glioma Study Group. Five-aminolevulinic acid for fluorescence-guided resection of recurrent malignant gliomas: a phase ii study. Neurosurgery, 65: 1070–1076, 2009
Kostron H, Fiegele Th, Akatuna E. Combination of FOSCAN® mediated fluorescence guided resection and photodynamic treatment as new therapeutic concept for malignant brain tumors. Med Laser Appl, 21: 285–290, 2006
Bauer R, Kostron H. Influence of reoperation of overall survival in recurrent Glioblastoma multiforme. 2010. (in preparation)
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kostron, H., Bauer, R. Management of recurrent malignant glioma – neurosurgical strategies. Wien Med Wochenschr 161, 20–21 (2011). https://doi.org/10.1007/s10354-010-0861-7
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s10354-010-0861-7
Schlüsselwörter
- Rezidiviertes malignes Gliom
- Neurochirurgische Intervention
- Individualisiertes Vorgehen
- 5-Ala in vivo fluoreszenz