Subependymal giant cell astrocytoma medical therapy: Difference between revisions
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:*Tumor causing significant [[hydrocephalus]] and impending [[brain herniation|herniation]] | :*Tumor causing significant [[hydrocephalus]] and impending [[brain herniation|herniation]] | ||
:*[[infection|Severe infections]] | :*[[infection|Severe infections]] | ||
*The adverse effects of [[rapamycin]] include:<ref name="pmid21465222">{{cite journal| author=Campen CJ, Porter BE| title=Subependymal Giant Cell Astrocytoma (SEGA) Treatment Update. | journal=Curr Treat Options Neurol | year= 2011 | volume= 13 | issue= 4 | pages= 380-5 | pmid=21465222 | doi=10.1007/s11940-011-0123-z | pmc=PMC3130084 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21465222 }} </ref> | |||
:*[[Aphthous ulcers]] | |||
:*[[Hypercholesterolemia]] | |||
:*[[acne|Acneiform rash]] | |||
:*[[wound healing|Delayed wound healing]] | |||
:*[[Thrombocytopenia]] | |||
:*[[Immunosuppression]] | |||
==Reference== | ==Reference== | ||
Revision as of 19:23, 5 November 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]
Overview
The predominant therapy for subependymal giant cell astrocytoma is surgical resection. Adjunctive chemotherapy may be required.[1]
Medical Therapy
The treatment options for subependymal giant cell astrocytoma include the following:[2][1]
Treatment of subependymal giant cell astrocytoma | |||||||||||||||||||||||||||||||||||||||||
Surgery | Gamma knife radiosurgery | Chemotherapy | |||||||||||||||||||||||||||||||||||||||
Rapamycin | Everolimus | ||||||||||||||||||||||||||||||||||||||||
Chemotherapy
Pharmacologic medical therapies for subependymal giant cell astrocytoma include either rapamycin or everolimus.[1]
Rapamycin
- The goal of rapamycin (sirolimus) is to either shrink or stabilize the subependymal giant cell astrocytoma.
- Approximately 65% of the tumor mass is reduced by the rapamycin therapy.
- Patients from the initial report of rapamycin for subependymal giant cell astrocytoma have been receiving this agent for in excess of 10 years with acceptable adverse events.[3]
- It may be possible to reduce the dose of rapamycin after an initial response with preservation of tumor volume reduction.
- Subependymal giant cell astrocytoma growth during the rapamycin therapy is extremely uncommon, and most of the individuals who exhibit such growth have remained asymptomatic.
- Contraindications to the rapamycin therapy include:
- Tumor causing significant hydrocephalus and impending herniation
- Severe infections
Reference
- ↑ 1.0 1.1 1.2 1.3 Campen CJ, Porter BE (2011). "Subependymal Giant Cell Astrocytoma (SEGA) Treatment Update". Curr Treat Options Neurol. 13 (4): 380–5. doi:10.1007/s11940-011-0123-z. PMC 3130084. PMID 21465222.
- ↑ Jóźwiak S, Nabbout R, Curatolo P, participants of the TSC Consensus Meeting for SEGA and Epilepsy Management (2013). "Management of subependymal giant cell astrocytoma (SEGA) associated with tuberous sclerosis complex (TSC): Clinical recommendations". Eur J Paediatr Neurol. 17 (4): 348–52. doi:10.1016/j.ejpn.2012.12.008. PMID 23391693.
- ↑ Roth, Jonathan; Roach, E. Steve; Bartels, Ute; Jóźwiak, Sergiusz; Koenig, Mary Kay; Weiner, Howard L.; Franz, David N.; Wang, Henry Z. (2013). "Subependymal Giant Cell Astrocytoma: Diagnosis, Screening, and Treatment. Recommendations From the International Tuberous Sclerosis Complex Consensus Conference 2012". Pediatric Neurology. 49 (6): 439–444. doi:10.1016/j.pediatrneurol.2013.08.017. ISSN 0887-8994.