Neurokirurški pristup u liječenju gliomskih tumora niskog stupnja malignosti

master's thesis

• Title (english): A neurosurgical treatment of low-grade gliomas
• Author: Andrea Blažević
• Mentor: Darko Chudy (mentor)
• Committee member: Marko Radoš (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Darko Chudy (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Neurology

Abstract

Tumori središnjeg živčanog sustava heterogena su skupina benignih i malignih neoplazmi koji mogu nastati iz moždanog tkiva, moždanih ovojnica, kranijalnih živaca, krvnih žila ili rezidualnog embrionalnog tkiva, te metastatskih neoplazmi. Tumori se razvrstavaju prema TNM i WHO klasifikaciji. Svjetska zdravstvena organizacija (WHO) predstavila je 2016. godine nadopunjenu klasifikaciju primarnih tumora mozga koja uključuje i molekularne faktore. Gliomi su najčešći primarni tumori mozga u odraslih. U gliomske tumore niskog gradusa, prema WHO definiciji, ubrajaju se tumori gradusa I i gradusa II. Uvidom u molekularni profil gliomskih tumora niskog gradusa i sa spoznajom da imaju relativno velik potencijal prelaska u gliome višeg gradusa, paradigma liječenja se promijenila. Neurokirurško liječenje uz kasniji onkološki tretman pokazalo se kao najbolja opcija. Ciljevi ovog istraživanja su višestruki. Opći cilj istraživanja je pokazati kako različiti neurokirurški pristupi utječu na ishod bolesti i učestalost
recidiva. Specifični ciljevi istraživanja su pokazati razliku u ishodu liječenja nakon stereotaktičke biopsije i nakon otvorene operacije i pokazati povezanost ishoda liječenja i primjene onkološke terapije. Patohistološki nalazi su dobiveni stereotaktičkom biopsijom, dok su ostali podaci dobiveni analizom postojećih podataka iz povijesti bolesti. Rezultati su pokazali da totalna resekcija tumora ima za rezultat poboljšanje kvalitete života i da u pacijenata kojima je tumor uspješno u potpunosti uklonjen nije došlo do recidiva bolesti. Bolesnici kojima nije potpuno odstranjen tumor imali su dulje vrijeme bez progresije bolesti ukoliko je provedeno i adjuvantno onkološko liječenje.

Abstract (english)

Tumors of the central nervous system are a heterogeneous group of benign and malignant tumors that can arise from brain tissue, meninges, cranial nerves, blood vessels or residual embryonic tissue and metastatic neoplasms. Tumors are classified according to the TNM and WHO classification. The World Health Organization (WHO) presented a new classification in 2016. which included molecular factors. Gliomas are the most common primary brain tumors in adults. Low-grade gliomas are, according to the WHO definition, grade I and grade II tumors. By examining the molecular profile of low-grade gliomas and with the realization that they have a relatively high potential of transformation to higher grade gliomas,
the paradigm of treatment has changed. Neurosurgical treatment with adjuvant radiochemotherapy proved to be the best option. The goals of this research are multiple. The main goal is to show how different neurosurgical approaches affect the outcome of the disease and the frequency of recidivism. Specific research goals are to show the difference in the outcome after stereotactic biopsy and after open surgery, and to show the correlation between treatment outcomes and the application of adjuvant oncology therapy. Histological samples were obtained with a stereotactic biopsy, while other data were analyzed and obtained from the existing medical records. The results showed that the total resection of the tumor resulted in improvement of the life quality, and that in patients whose tumor was successfully completely removed, there was no recurrence of the disease. Patients whose tumor was not completely removed had a prolonged period of time without disease progression if adjuvant oncology treatment was administered.

• Keywords: gliomski tumori niskog gradusa; stereotaksijska biopsija; otvorena operacija; adjuvantno onkološko liječenje
• Keywords (english): low-grade gliomas; stereotactic biopsy; open surgery; adjuvant oncology treatment
• Language: croatian
• URN:NBN: urn:nbn:hr:105:738144
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-03-01 09:18:33