Astrocytoma

• Prognosis and therapy according to WHO grade

introduction

A brain tumor that is made up of astrocytes is called an astrocytoma. Astrocytes are the so-called supporting tissue cells of the brain, they are also called glial cells. The term for tumors of this tissue in the brain and spinal cord is derived from this term: gliomas. Astrocytomas are therefore included in the glioma group of tumors.

Prognosis and therapy according to WHO grade

The malignancy of such a brain tumor is determined by the WHO degree read, which shows how the tumor cells differ from the normal, healthy glial cells. The clearer the difference, the more malignant the brain tumor.
The therapy options and the prognosis are also based on the WHO grade classification Glioblastoma is the most malignant glioma (WHO grade IV) and has the worst prognosis. In contrast, that is pilocytic astrocytoma (WHO grade I) by a Operation completely curable. It can be seen here that the prognosis deteriorates as the WHO grade rises. Patients with low-grade astrocytomas can often survive the disease for several years.

Classification of gliomas according to WHO grades

• Grade I WHO - Pilocytic Astrocytoma
• Grade II WHO - Differentiated astrocytoma or oligodendroglioma
• Grade III WHO - anaplastic astrocytoma or anaplastic oligodendroglioma
• Grade IV WHO - grade 4 glioblastoma

causes

The causes of an astrocytoma are largely unexplained. The tumor develops from the Supporting tissue ("glia") of the brain and occurs at the Hereditary disease neurofibromatosis type 1 particularly common as pilocystic astrocytoma.
Likewise for people with increased radiation exposure an increased risk of astrocytoma was observed, which means that the radiation can be determined as the cause.
Also at Glioblastoma are the exact ones Causes not yet known and increased radiation exposure is suspected as a risk for the disease.

Symptoms

Most of them suffer from astrocytoma and also from glioblastoma Middle to advanced age men.
The most common symptoms are:

• Seizures (epileptic fits)
• Signs of increased intracranial pressure (nausea, vomiting, ...)

The tumor spreads and presses on the Nerve tracts in brain or Spinal cord, it can also lead to neurological deficits:

• Paralysis
• Pain
• Numbness / sensitivity disorders
• Visual disturbances
• Personality changes

diagnosis

In order to be able to make the diagnosis of astrocytoma or glioblastoma, imaging procedures how Computed Tomography (CT) and Magnetic resonance imaging (MRI) of the head is essential.

therapy

To treat the astrocytoma effectively, the tumor needs to be treated whenever possible completely removed become. If this is not possible, an attempt is made to at least Reduce tumor size.
There are several treatment routes here that are often combined with each other Need to become):

• surgery (Surgery)
• Radiation treatment
• chemotherapy

Which procedures in individual case applied depends on the symptoms, the WHO grade of the tumor, the general physical condition and also the age of the affected patient.

Prevention

Until now there is no known general measuresthat can help prevent astrocytoma or glioblastoma. However, it is generally recommended Avoid unnecessary radiation exposure (especially in children) and contact with pollutants and chemicalssuspected of causing cancer. A healthy lifestyle with a varied, low-fat diet, regular exercise and the renouncement of cigarettes and alcohol helps to reduce the risk of cancer and keeps the body as healthy as possible.

Medical therapy

If an operation of the astrocytoma is planned, it must be done with a Cortisone preparation (dexamethasone) treated to let the tumor swell. The administration of cortisone is also possible during radiation therapy, as the radiation therapy can initially exacerbate edema.
Accompanying symptoms of an astrocytoma or glioblastoma can epileptic seizures (Seizures). Here must be with appropriate Anti-epileptic drugs prevent further seizures to protect the patient.

surgery

Through an operation is a effective treatment of the astrocytoma or the glioblastoma possible and it also offers the possibility of pathologically removing the tumor tissue under the Examine microscope to be able to. In this way, it can be determined whether the tumor could be completely removed and the WHO grade of the tumor.

The so-called pilocytic astrocytoma (WHO grade I) can usually be done through an operation remove completely. This is also mostly successful in grade II astrocytomas. Grade III and grade IV tumors (e.g. Glioblastomas), on the other hand, have grown into the neighboring tissue in such a way that a complete removal is impossible in most cases. Here an operation is only used for Shrinking the tumorto the intracranial pressure and thus the acute symptoms improve the patient.
Then a Radiation treatment or chemotherapy used for further treatment of the tumor.

Radiation and chemotherapy

At low WHO grade of the astrocytoma is done after the operation radiotherapyif the post-operative CT check-up shows that tumor residues remained in the brain after the operation and that these may continue to grow. Radiation therapy is also recommended if the Tumor not completely removed from the start can be.

Also get patients with one Astrocytoma grade III or IV an accompanying Radiation and chemotherapy regardless of the surgically removed tumor mass.
For astrocytomas Grade II to IV becomes radiation therapy often by a Chemotherapy expanded. However, it is important that both Patient's blood count normal is, as well there are no disorders / diseases of the liver, kidneys, respiratory tract or the cardiovascular system.