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| Neuro-oncology. 2022 Aug 1. pii: 6652587. doi: 10.1093/neuonc/noac188 |
| Eano-Euracan-Sno Guidelines on Circumscribed Astrocytic GLIOMAS, Glioneuronal and Neuronaltumors. |
| Rudà R1, Capper D2, Waldman AD3, Pallud J4, Minniti G5, Kaley TJ6, Bouffet E7, Tabatabai G8, Aronica E9, Jakola AS10, Pfister SM11, Schiff D12, Lassman AB13, Solomon DA14, Soffietti R15, Weller M16, Preusser M17, Idbaih A18, Wen PY19, van den Bent MJ20 |
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Abstract In the new WHO 2021 Classification of CNS Tumors the chapter "Circumscribed astrocytic gliomas, glioneuronal and neuronal tumors" encompasses several different rare tumor entities, which occur more frequently in children, adolescents and young adults. The Task Force has reviewed the evidence of diagnostic and therapeutic interventions, which is low particularly for adult patients, and draw recommendations accordingly. Tumor diagnosis, based on WHO 2021, is primarily performed using conventional histological techniques; however, molecular workup is important for differential diagnosis, in particular DNA methylation profiling for the definitive classification of histologically unresolved cases. Molecular factors are increasingly of prognostic and predictive importance. MRI finding are non specific, but for some tumors are characteristic and suggestive. Gross total resection, when feasible, is the most important treatment in terms of prolonging survival and achieving long-term seizure control. Conformal radiotherapy should be considered in grade 3 and incompletely resected grade 2 tumors. In recurrent tumors reoperation and radiotherapy, including stereotactic radiotherapy, can be useful. Targeted therapies may be used in selected patients: BRAF and MEK inhibitors in pilocytic astrocytomas, pleomorphic xanthoastrocytomas, and gangliogliomas when BRAF altered, and mTOR inhibitor everolimus in subependymal giant cells astrocytomas .Sequencing to identify molecular targets is advocated for diagnostic clarification and to direct potential targeted therapies. |
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© The Author(s) 2022. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. |
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KEYWORDS: circumscribed astrocytic gliomas, glioneuronal tumors, guideline, neuronal tumors |
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Publikations ID: 35908833 Quelle: öffnen |
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