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| ==Treatment== | | ==Treatment== |
| [[Brain tumor medical therapy|Medical therapy]] | [[Brain tumor surgery|Surgical options]] | [[Brain tumor primary prevention|Primary prevention]] | [[Brain tumor secondary prevention|Secondary prevention]] | [[Brain tumor cost-effectiveness of therapy|Financial costs]] | [[Brain tumor future or investigational therapies|Future therapies]] | | [[Brain tumor medical therapy|Medical therapy]] | [[Brain tumor surgery|Surgical options]] | [[Brain tumor primary prevention|Primary prevention]] | [[Brain tumor secondary prevention|Secondary prevention]] | [[Brain tumor cost-effectiveness of therapy|Financial costs]] | [[Brain tumor future or investigational therapies|Future therapies]] |
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| ==Treatment and prognosis==
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| [[Meningiomas]], with the exception of some tumors located at the skull base, can be successfully removed surgically, but the chances are less than 50%. In more difficult cases, [[stereotactic]] [[radiosurgery]], such as [[Gamma Knife]] [[radiosurgery]], remains a viable option.
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| Most [[pituitary adenoma]]s can be removed surgically, often using a minimally invasive approach through the [[nasal cavity]] and skull base (trans-nasal, trans-sphenoidal approach). Large [[pituitary adenoma]]s require a [[craniotomy]] (opening of the skull) for their removal. Radiotherapy, including [[stereotactic]] approaches, is reserved for the inoperable cases.
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| Although there is no generally accepted therapeutic management for primary brain tumors, a surgical attempt at tumor removal or at least cytoreduction (that is, removal of as much tumor as possible, in order to reduce the number of tumor cells available for proliferation) is considered in most cases<ref>Nakamura M, Konishi N, Tsunoda S, Nakase H, Tsuzuki T, Aoki H, Sakitani H, Inui T, Sakaki T. ''Analysis of prognostic and survival factors related to treatment of low-grade astrocytomas in adults.'' Oncology 2000;58:108-16. PMID 10705237.</ref>. However, due to the infiltrative nature of these lesions, tumor recurrence, even following an apparently complete surgical removal, is not uncommon. Postoperative radiotherapy and chemotherapy are integral parts of the therapeutic standard for malignant tumors. Radiotherapy may also be administered in cases of "low-grade" gliomas, when a significant tumor burden reduction could not be achieved surgically.
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| Survival rates in primary brain tumors depend on the type of tumor, age, functional status of the patient, the extent of surgical tumor removal, to mention just a few factors<ref>Nicolato A, Gerosa MA, Fina P, Iuzzolino P, Giorgiutti F, Bricolo A. ''Prognostic factors in low-grade supratentorial astrocytomas: a uni-multivariate statistical analysis in 76 surgically treated adult patients.'' Surg Neurol 1995;44:208-21; discussion 221-3. PMID 8545771.</ref>.
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| Patients with benign gliomas may survive for many years<ref>Janny P, Cure H, Mohr M, Heldt N, Kwiatkowski F, Lemaire JJ, Plagne R, Rozan R. ''Low grade supratentorial astrocytomas. Management and prognostic factors.'' Cancer 1994;73:1937-45. PMID 8137221.</ref><ref>Piepmeier J, Christopher S, Spencer D, Byrne T, Kim J, Knisel JP, Lacy J, Tsukerman L, Makuch R. ''Variations in the natural history and survival of patients with supratentorial low-grade astrocytomas.'' Neurosurgery 1996;38:872-8; discussion 878-9. PMID 8727811.</ref>
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| while survival in most cases of [[glioblastoma multiforme]] is limited to a few months after diagnosis.
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| The main treatment option for single metastatic tumors is surgical removal, followed by radiotherapy and/or chemotherapy. Multiple metastatic tumors are generally treated with radiotherapy ''and'' chemotherapy. [[Stereotactic]] [[radiosurgery]], such as [[Gamma Knife]] [[radiosurgery]], remains a viable option.
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| However, the prognosis in such cases is determined by the primary tumor, and it is generally poor.
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| A shunt operation is used not as a cure but to relieve the symptoms.[http://www.emedicinehealth.com/normal_pressure_hydrocephalus/page9_em.htm] The [[hydrocephalus]] caused by the blocking drainage of the [[cerebrospinal fluid]] can be removed with this operation.
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| ==References== | | ==References== |
