RESUMO
Radiation therapy is often considered the treatment of choice for low-grade gliomas. However, given the long-term effects of radiation on the developing brain, the appropriate use of radiation therapy in pediatric patients remains controversial. The purpose of this study was to evaluate progression-free survival (PFS) of pediatric low-grade glioma patients treated with radiation therapy. Data were obtained through a retrospective chart review of patients treated between 1991 and 2008 from a single tertiary care center in the midwest. The study population consisted of 17 patients, of whom 8 (47%) had tumor recurrence after radiation therapy. The median follow-up time was 8.2 years, with a range of 2.3 to 17.2 years. The median age at diagnosis was 5.4 years, and the median age at radiation therapy was 9.4 years. The 3- and the 10-year PFS were 69%± 11.7% and 46%± 13.3%, respectively. A significant difference in PFS was seen when comparing brainstem tumors with hypothalamic/optic pathway tumors (P=0.019). Differences in PFS based on the age at diagnosis, the extent of initial surgery, and indication for radiation therapy were not significant. A larger multicenter study is needed to better assess PFS in these patients.
Assuntos
Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/radioterapia , Glioma/patologia , Glioma/radioterapia , Recidiva Local de Neoplasia/patologia , Adolescente , Neoplasias Encefálicas/cirurgia , Neoplasias do Tronco Encefálico/patologia , Neoplasias do Tronco Encefálico/radioterapia , Neoplasias do Tronco Encefálico/cirurgia , Criança , Pré-Escolar , Terapia Combinada , Intervalo Livre de Doença , Feminino , Seguimentos , Glioma/cirurgia , Humanos , Neoplasias Hipotalâmicas/patologia , Neoplasias Hipotalâmicas/radioterapia , Neoplasias Hipotalâmicas/cirurgia , Masculino , Gradação de Tumores , Estudos Retrospectivos , Resultado do Tratamento , Vias Visuais/patologia , Adulto JovemRESUMO
OBJECTIVE: To introduce effectiveness of tumor treating fields (TTFields), how to care for the patient with this type of treatment, and the critical role the nurse plays in educating the patient about this innovative treatment. DATA SOURCES: Published research and articles in both nursing and medical journals. CONCLUSION: TTFields are an antimitotic therapy delivered via transducer arrays that are worn on the scalp to treat newly diagnosed and recurrent glioblastoma, the most aggressive primary brain cancer. Oncology nurses are integral in educating and supporting the patient in its use and managing its of treatment. IMPLICATIONS FOR NURSING PRACTICE: Nurses are on the front line of educating the patient, caregivers, and the larger body of clinicians who deliver care to these patients. Education provided by nurses increases the patients' knowledge, and thus compliance, as well as the overall outcome through proper usage of TTFields.
Assuntos
Neoplasias Encefálicas/terapia , Divisão Celular/efeitos da radiação , Terapia por Estimulação Elétrica/métodos , Glioblastoma/terapia , Glioma/terapia , Recidiva Local de Neoplasia/terapia , Enfermagem Oncológica/métodos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Atypical teratoid/rhabdoid tumor is a rare, highly malignant central nervous system tumor most commonly occurring in very young children. Atypical teratoid/rhabdoid tumor most often presents as an expanding mass with symptoms consistent with the location of the tumor and may present with metastatic leptomeningeal disease. The authors describe 2 cases of rapidly progressive, diffuse leptomeningeal atypical teratoid/rhabdoid tumor without a solid primary mass. These cases demonstrate a clinical picture that can easily be confused with a basilar meningitis, encephalomyelitis, or vasculitis.