title: Spinal cord gliomas: management and outcome with reference to adjuvant therapy.
abstract: The authors review their experience with 19 consecutive cases with either astrocytic tumour (glioblastoma multiforme one, anaplastic astrocytoma one, astrocytoma 4, pilocytic astrocytoma 4) or ependymoma (10 tumours in 9 patients) of the spinal cord who were treated during the period from 1982 to 1996. The patients included 10 male and 9 female patients with a median age of 38 years. The main tumour locations included the cervicomedullary region 5 the cervical cord (8), the thoracic cord (5) and one each in the thoracolumbar region and conus medullaris. While a total removal of the tumour was achieved in 8 out of 10 ependymomas, the initial treatment for astrocytic tumours was a partial resection in 5, and biopsy in the remaining 5. As adjuvant treatment, 8 patients received radiation therapy and 2 received chemotherapy. Two patients with an astrocytic tumour received chemotherapy only, while the remaining 9 received neither radiation therapy nor chemotherapy initially. After these treatments, 6 out of the 8 patients with low grade astrocytoma have remained alive for 1.3-12.6 years, while 2 patients with high grade astrocytic tumours died within 15 months following surgery. Eight out of 9 patients with an ependymoma have remained alive for 3.0-12.3 years, while one committed suicide 2 years after surgery. As a result, 14 patients are still alive; half of them are accompanied by a mild neurological dysfunction, while the remaining one has a moderate deficit. The postoperative results and the rationale for surgery is discussed, and an approach for utilising adjuvant therapy for high grade tumours is also suggested.
authors.affiliation: Department of Neurosurgery, Neurological Institute, Graduate School of Medicine, Kyushu University, Fukuoka, Japan. shunji@ns.med.kyushu-u.ac.jp
authors.forename: S
authors.initials: S
authors.lastname: Nishio
authors.forename: T
authors.initials: T
authors.lastname: Morioka
authors.forename: K
authors.initials: K
authors.lastname: Fujii
authors.forename: T
authors.initials: T
authors.lastname: Inamura
authors.forename: M
authors.initials: M
authors.lastname: Fukui
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001254:Astrocytoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D002675:Child, Preschool; D004806:Ependymoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*