1.What kind of tumor is glioma?
Glioma is a common malignant tumor in the skull, accounting for about 40%-50% of all intracranial tumors. According to the differentiation of tumor cells, it can be divided into astrocytoma, oligodendroglioma, ventricular meningioma, medulloblastoma, glioblastoma multiforme, etc.
2.How is the pathology of glioma graded?
The World Health Organization (WHO) classifies the pathology of glioma into four grades, namely: WHO grade І, WHO grade Ⅱ, WHO grade Ⅲ, WHO grade III. Currently, WHO grade І is considered as benign tumor. With the increase of pathological grade, the pathological malignancy increases and the prognosis becomes worse.
3. What is the clinical presentation of glioma? How to detect early?
Glioma, like other intracranial tumors, can have symptoms of increased intracranial pressure such as headache, vomiting and optic nerve papillary edema (blurred vision), and can also have different clinical manifestations depending on the growth site of the tumor, such as epilepsy (“crohns”), inflexible limb movement, numbness of limbs, unclear speech or aphasia, blurred vision and unstable walking. blurred vision, and unstable walking.
How to find the above unexplained symptoms, you should go to the hospital as soon as possible to check such as head CT, to achieve early detection.
4.Suspected intracranial tumor, how should be examined?
If you have clinical symptoms of intracranial tumor, you should take active imaging examinations, including head CT examination and MRI examination, which can basically make a clear diagnosis.
5.What are the symptoms of increased intracranial pressure?
The main symptoms are headache, vomiting and optic nerve papillary edema, which are called the three main signs of increased intracranial pressure. The severity of the symptoms varies from patient to patient.
6. Does increased intracranial pressure mean that I have glioma? Is there any basis for this?
Glioma patients will have symptoms of increased intracranial pressure, but increased intracranial pressure does not necessarily mean glioma. The diagnosis of glioma patients should be confirmed by imaging and surgery or biopsy to obtain tumor tissue for pathological examination.
7.Where can glioma grow?
Glioma can grow in the cerebral hemispheres (e.g. frontal lobe, parietal lobe, temporal lobe, occipital lobe, insula, basal ganglia, intracerebral ventricles, etc., involving two or more lobes), brain stem, cerebellum, etc. Spinal cord glioma grows in the spinal cord.
8.How is glioma treated?
Surgery is preferred for glioma, and then reasonable radiotherapy and chemotherapy are selected according to the postoperative pathology. The treatment of glioma is individualized and comprehensive.
9.How can glioma be treated in speech and motor sensory areas?
The first choice for glioma treatment is surgery, followed by postoperative adjuvant radiotherapy. Since the tumor grows in functional areas such as speech area and motor-sensory area (parietal lobe), improper surgery may aggravate the clinical symptoms, and surgery in these areas depends on the experience and skill of the surgeon and whether the hospital is well-equipped. It is recommended to seek consultation with an experienced doctor at a large hospital.
10.Glioma is located in the left frontal lobe (speech area) and parietal lobe (central area) of the brain, what equipment is needed for surgery?
The left frontal lobe (speech area) and the parietal lobe (central area) are the most important functional areas of the cerebral cortex, and surgery can easily aggravate the symptoms. If the hospital has: neuronavigation equipment, intraoperative wake-up anesthesia technology and neurophysiological monitoring technology, it is helpful for intraoperative brain protection of brain functional area surgery.
11.Is surgery of glioma risky? What are the complications?
In large hospitals with good surgical conditions, the risk of surgery will be small and the chance of complications will be very low. The mortality rate of surgery in Anhui Provincial Hospital is less than 1%. Post-operative complications are very complicated and the incidence of complications varies depending on the individual patient’s condition, the nature of the tumor, and the surgical approach taken.
12.What if the condition of glioma deteriorates and recurs?
After a recurrence of glioma patients, according to the MRI results, it is recommended to try a second surgery with adjuvant treatment of radiotherapy and chemotherapy. An experienced neurosurgeon is needed to determine the recurrent glioma in a comprehensive judgment and decide further treatment plan.
13.Can glioma be treated with Gamma Knife?
Gamma knife is a kind of radiotherapy, gamma knife is suitable for tumors with clear boundaries and less than 30mm in diameter, while gliomas with unclear boundaries are generally not recommended for gamma knife treatment.
Surgery is preferred for glioma, and radiation therapy and chemotherapy are administered after surgery.
14.How to improve the resistance of glioma patients? How to control the recurrence of tumor?
Glioma cannot be completely removed due to its invasive growth characteristics and is prone to recurrence. Patients need to actively cooperate with the treatment and keep a good attitude to face the development of the disease. Glioblastoma is the most malignant and has a poor prognosis. Therefore, if economic conditions allow, for recurrent glioblastoma, how can it be removed or operated, and continue chemotherapy after surgery, or you can try molecular targeted drug bevacizumab treatment.
15.How to better inhibit recurrence of glioblastoma and what are the good methods?
Bevacizumab is the drug of choice for the treatment of glioblastoma recurrence (2013 NCCN guidelines). The Chinese glioma treatment guidelines released in 2012 also suggest the use of bevacizumab in the treatment of recurrent glioma. Its 6-month disease progression-free chance is about 40%-50%.
16.How is hairy cell astrocytoma treated?
Hairy cell astrocytoma, which occurs in the cerebellar hemispheres of children, is a WHO grade І glioma with the best prognosis. Surgery should be the first choice. If the surgery is complete, there is no need for radiotherapy and chemotherapy, and the chance of recurrence is very small. Close follow-up is recommended.
17.How many courses of chemotherapy are good for glioma? Are there any side effects?
At present, the main chemotherapy drug is oral tidemetazolamide. The course of chemotherapy needs to be formulated according to the pathological classification and by experienced physicians. The duration of chemotherapy is usually 4-6 courses, but can be extended for WHO grade IV patients. Chemotherapy drugs have certain side effects, such as gastrointestinal reactions like nausea and vomiting, and bone marrow suppression. Regular blood tests and blood biochemistry should be performed.
18.How to continue the treatment after the second surgery of glioma?
In case of recurrence, the size and direction of the growth of the lesion should be determined according to the results of MRI examination. If surgery is possible, active reoperation is advocated. However, it should be emphasized that after reoperation, chemotherapy support must also be needed. Otherwise, the lesions will have to recur soon.
19.How long do I need to take sodium propionate for glioma patients?
Sodium propionate is an anti-epileptic drug. Patients with glioma who do not have epilepsy symptoms before surgery need to take antiepileptic drugs for at least three months after surgery, and after three months, they can go to the hospital and ask the doctor to decide whether to stop or reduce the drug according to the patient’s condition, etc. If there is epilepsy before surgery as well as epilepsy-prone parts of the surgery, physicians will determine on a case-by-case basis, and it is recommended to take them under the guidance of physicians.
20.What should I do if I lose my appetite after chemotherapy for glioma?
Loss of appetite after chemotherapy is a normal reaction, diet is based on a small number of meals, drink more water, can relieve stomach discomfort, according to their “food” good, choose high calorie, high protein, high fiber, easy to digest food, avoid sweet, fried, high fat diet.
21.What should glioma patients pay attention to in life and diet
Diet is mainly light, less spicy and oily food, more high protein food, more vegetables and fruits, such as mushrooms, tomatoes, lettuce, etc. can play a role in fighting and curing cancer.
22.Is Chinese medicine effective for glioma?
There is no evidence to prove the effectiveness of Chinese medicine on glioma.
23.What programs and measures are available for the treatment of glioma?
The “Glioma Treatment Center”, with advanced surgical equipment such as neuronavigation, microscope, neuroelectrophysiological equipment and monitoring technology, and intraoperative anesthesia arousal technology, can perform individualized surgical treatment for glioma. For the postoperative period, we will evaluate and develop reasonable comprehensive treatment plans such as radiotherapy and chemotherapy according to different pathological levels.
24.How is brainstem glioma treated?
Brainstem is the center of human life. Brainstem glioma is very difficult and risky to operate due to the specificity of the growth site and the fact that glioma in this area often grows diffusely and infiltratively. Therefore, the vast majority of cases cannot be surgically removed, and only a small percentage of cases can be operated. Whether surgery is possible or not depends on the location of tumor invasion, the growth pattern and the size of the tumor. Adjuvant chemotherapy is available, but in general, the prognosis of brainstem glioma is poor.
25.What if glioma in special parts of the brain cannot be removed directly?
For special parts of the brain, such as basal ganglia, functional area, deep brain, etc., which cannot be removed directly, stereotactic biopsy can be used to obtain tumor tissues to clarify the diagnosis and pathological level of glioma and provide a basis for radiotherapy and chemotherapy. Stereotactic technique requires high technology and special equipment, not all hospitals can carry out it, only some big hospitals can carry out this kind of surgery.
26.How is spinal cord glioma treated?
Glioma of the spinal cord is an intramedullary tumor of the spinal cord, which mainly includes astrocytoma and ventricular meningioma of the spinal cord. Due to the development of modern technology, glioma of the spinal cord can be treated surgically, but it requires hospitals with advanced microsurgical techniques and special equipment to carry out. For ventricular meningioma of the spinal cord, surgery should be aggressively performed, and the prognosis is still relatively good if the surgery can be completely removed. For astrocytomas of the spinal cord, they can be partially excised, and postoperative chemotherapy, etc. Whether radiotherapy is given depends on the specific situation.