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Astrocytic Tumors of the Spinal Cord

  • Tania Kaprealian
Chapter

Abstract

Primary spinal cord tumors are rare and account for 2–4% of all adult central nervous system tumors. Astrocytomas comprise approximately 6–8% of all spinal cord tumors. Tumor histology and grade are the most significant prognostic factors of primary spinal cord astrocytomas affecting overall survival.

MRI is the primary imaging modality used to diagnose intramedullary spinal tumors.

Achieving a good resection can be very difficult in spinal astrocytomas due to the involvement of the spinal cord itself. However, maximal safe surgical resection or biopsy is beneficial in diagnosing the patient and potentially providing symptom relief and improved outcomes.

Adjuvant radiation therapy is a useful yet controversial treatment modality in the treatment of spinal astrocytomas given the low rates of gross total resection. It is generally accepted to treat high-grade spinal astrocytomas with postoperative radiation therapy as well as in cases of subtotally resected grade II spinal astrocytomas. Whereas, resected spinal pilocytic astrocytomas and gross totally resected grade II spinal astrocytomas may be observed. The role and benefit of chemotherapy require additional studies; however, extracting from intracranial data, temozolomide and bevacizumab are commonly used, particularly in high-grade tumors.

Keywords

Spinal cord low-grade astrocytoma High-grade astrocytoma Pilocytic Glioblastoma Central nervous system 

Abbreviations

2-D

Two-dimensional

3-D

Three-dimensional

AA

Anaplastic astrocytoma

AP-PA

Anterior/posterior-posterior/anterior

Cm

Centimeters

CNS

Central nervous system

CSF

Cerebrospinal fluid

CT

Computerized tomography

CTV

Clinical target volume

CTx

Chemotherapy

GBM

Glioblastoma

GTV

Gross tumor volume

HGA

High-grade astrocytoma

IMRT

Intensity-modulated radiation therapy

LGA

Low-grade astrocytoma

MS

Median survival

MV

Megavoltage

NR

Not reported

OS

Overall survival

PCV

Procarbazine, lomustine, and vincristine

PFS

Progression-free survival

PTV

Planning target volume

RFS

Recurrence-free survival

RT

Radiation therapy

RTOG

Radiation Therapy Oncology Group

TD

Tolerance dose

VEGF

Vascular endothelial growth factor

WHO

World Health Organization

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Radiation OncologyUniversity of California, Los AngelesLos AngelesUSA

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