What Factors Affect an Astrocytoma Prognosis?

The disease develops slowly, with an average course of about 2 years, and some can be as long as 10 years. Symptoms vary from site to site. Most of them first appear as localized signs and symptoms caused by direct destruction of the tumor. Later, symptoms of increased intracranial pressure may occur. Mainly the symptoms of increased intracranial pressure and damage to one side of the cerebellum. The latter is awkward limb movements, the upper limbs are more severe than the lower limbs, manifested as instability in holding objects, can not be fastened with buttons and eating with a spoon, and other fine movement disorders, affecting the cerebellar vermiform balance may appear. In more than 70% of children, coarse ocular tremor can be seen, and cerebellar language (unclear articulation or explosive language) can also be present when cerebellar damage is severe. Children may have low muscle tone and tendon reflexes, about 1/7 have a forced head position, and "cerebellar crisis" may occur in the later stages.

Pediatric astrocytoma

Astrocytoma is a more benign glioma, which occurs in the cerebellar hemisphere in children, and is one of the common posterior cranial fossa tumors in children. It grows slowly, differentiates well, and has a good prognosis. Clinically, the symptoms are increased intracranial pressure and damage to one side of the cerebellum.

Pediatric astrocytoma symptoms and signs

Pediatric astrocytoma medication

The tumor is not sensitive to radiotherapy and chemotherapy, so surgical resection should be preferred. If the tumor is in the cystic type, the tumor nodules can be cured; if it is a solid tumor, it should be removed as much as possible; if the tumor invades the brainstem, a small amount of residue is allowed to avoid damage to the brainstem, followed by radiation therapy. However, it is still controversial whether to carry out conventional radiotherapy for residual tumors. Some people think that radiotherapy can inhibit tumor growth and improve survival rate. Others believe that radiotherapy cannot reduce the volume of residual tumors, but causes tumors to undergo malignant transformation due to low-dose irradiation, and has serious side effects of radiotherapy for young children. Therefore, it is advocated not to perform radiotherapy even if there are residual tumors. Our tendency is that radiation therapy should still be used for residual tumors. It is best to use stereotactic radiosurgery (SRS) to focus the radiation on the residual tumor targets and produce focal necrosis, which has less side effects than ordinary radiotherapy. In cases where the surgical resection is incomplete and the intracranial pressure is not alleviated, decompression surgery can be performed at the same time. Some cases of deep brain tumors cannot be surgically removed; decompression surgery can also be performed directly.

Pediatric astrocytoma diet health care

Pay attention to daily habits, pay attention to daily habits, mainly based on light food.

Preventive care of pediatric astrocytoma

Refer to general tumor prevention measures, understand the risk factors of tumors, and formulate corresponding prevention and treatment strategies to reduce the risk of tumors. There are two basic clues to preventing the occurrence of tumors. Even if tumors have begun to form in the body, they can also help the body to increase resistance. These strategies are as follows:

1. Avoiding harmful substances (cancer promoting factors) is to help us avoid or minimize exposure to harmful substances.

Some related factors of tumorigenesis should be prevented before onset. Many cancers can be prevented before they form. A 1988 report from the United States made a detailed comparison of international malignancies and proposed that many known malignancies can be prevented in principle by external factors, that is, about 80% of malignant tumors can be changed through simple lifestyle changes. prevention. Continued retrospective, a study conducted by Dr. Higginson in 1969 concluded that 90% of malignant tumors are caused by environmental factors. "Environmental factors" and "lifestyle" refer to the air we breathe, the water we drink, the food we choose to make, the habits of our activities, and our social relationships.

2. Improve the body's immunity against tumors Can help improve and strengthen the body's immune system to fight against tumors.

The focus of our current cancer prevention and treatment efforts should first focus on and improve those factors that are closely related to our lives, such as quitting smoking, eating properly, exercising regularly, and losing weight. Anyone who follows these simple and reasonable lifestyle common sense can reduce the chance of developing cancer.

The most important thing to improve the function of the immune system is diet, exercise and control of troubles, and healthy lifestyle choices can help us stay away from cancer. Maintaining a good emotional state and proper physical exercise can make the body's immune system in an optimal state, which is also good for preventing tumors and other diseases. Other studies have shown that proper activities not only enhance the human immune system, but also reduce the incidence of colon cancer by increasing the peristalsis of the human intestinal system. Here we mainly recognize some problems of diet in preventing tumorigenesis.

Human epidemiological and animal experiments have shown that vitamin A plays an important role in reducing the risk of cancer. Vitamin A supports normal mucosa and vision, and it directly or indirectly participates in most tissue functions of the body. Vitamin A is found in animal tissues such as liver, whole eggs, and whole milk. Plants are in the form of beta-carotene and carotenoids, which can be converted into vitamin A in the human body. Excessive intake of vitamin A can cause adverse reactions in the body, but -carotene and carotenoids do not have this phenomenon. Low levels of vitamin A in blood increase the risk of malignant tumors. Studies have shown that those with low levels of vitamin A in blood The increased risk of lung cancer was found in those who were admitted, while those with low levels of vitamin A intake in the blood of smokers were more likely to have lung cancer. Vitamin A and its mixtures can help eliminate free radicals in the body (free radicals can cause damage to genetic material), secondly can stimulate the immune system and help differentiate cells in the body to develop orderly tissues (while tumors are characterized by disorder) . Some theories suggest that vitamin A can help cells that are mutated by carcinogens at an early stage to reverse and become normal-growing cells.

In addition, some studies suggest that the supplementation of -carotene drugs alone does not reduce the risk of cancer. On the contrary, it increases the incidence of lung cancer slightly. However, when -carotene is combined with vitamin C, E and other anti-toxin substances, it has a protective effect. It shows up. The reason is that it can increase free radicals in the body when consumed by itself. In addition, there are interactions between different vitamins. Studies in humans and rats have shown that the use of -carotene can reduce vitamin E levels in the body by 40%, which is safer. The strategy is to eat different foods to maintain vitamin balance to protect against cancer, because some protective factors have not yet been found.

Vitamins C and E are another anti-tumor substance. They can prevent the harm of carcinogens such as nitrosamines in food. Vitamin C can protect sperm from genetic damage and reduce the risk of leukemia, kidney cancer and brain tumors in offspring. . Vitamin E can reduce the risk of skin cancer. Vitamin E has the same anti-tumor effect as vitamin C. It is an anti-toxin and scavenger for scavenging free radicals. The combined application of vitamins A, C, and E protects the body against toxins better than when applied alone.

The current research on phytochemistry has attracted widespread attention. Phytochemistry is a chemical substance found in plants, including vitamins and other substances found in plants. Chemical constituents in thousands of plants have been discovered, many of which have anticancer effects. The protective mechanisms of these chemicals not only reduce the activity of carcinogens but also enhance the body's immunity against the invasion of carcinogens. The antioxidant activity provided by most plants exceeds the protective effects of pure vitamins A, C, and E. For example, a cup of cabbage contains only 50 mg of vitamin C and 13 U of vitamin E, but its antioxidant activity is equivalent to 800 mg of vitamin C and The antioxidant activity of vitamin E at 1100U can be inferred that the antioxidant effect in fruits and vegetables is much stronger than the effect of vitamins as we know it. No doubt natural plant products will help prevent cancer in the future.

Pathological etiology of pediatric astrocytoma

There are two types of neuroepithelial tumors. One type is formed by interstitial cells (ie, glial cells) of the nervous system, called gliomas; the other type is formed by parenchymal cells (ie, neurons) of the nervous system, without a general name. Because the two types of tumors cannot be completely distinguished from the etiology and morphology, and gliomas are more common, neuronal tumors are included in gliomas. Tumors of neuroepithelial origin are the most common intracranial tumors, accounting for about 44% of total intracranial tumors.

Diagnosis of Pediatric Astrocytoma

It should be noted that it is different from cerebellar vascular reticuloma: the latter also appears on the image as a cystic mass containing nodules in the cerebellar hemisphere, which is more obvious than astrocytoma, and has a very low incidence in children. Accompanied by congenital multiple organ multiple cysts, erythrocytes and retinal vascular lesions, a few have a family history, digital subtraction angiography (DSA) can see deformed blood vessel mass.

Pediatric astrocytoma examination method

Laboratory inspection:

The general routine examination has no specific manifestations, and the diagnosis is mainly based on auxiliary examination.

Other auxiliary checks:

1. X-ray of the skull shows signs of increased intracranial pressure. When the tumor is located on the surface of the cerebellum, the occipital scales become thin and eroded. 4.3% of the tumors have calcified plaques.

2. CT examination showed low density of cerebellar hemispheres and midline sites, astrocytoma grade without enhancement, grade - with uneven enhancement. Some tumors appear as high-density and multiple-low-density foci (that is, the sac is inside the tumor), and some tumors are high-density tumor nodules (that is, the sac is inside the sac) on the inner wall of the low-density capsule.

3. MRI is an abnormal signal of T1 and T2 in the posterior cranial fossa. The cystic fluid is different from the cerebrospinal fluid due to the high protein content.

Pediatric astrocytoma complications

"Cerebellar crisis" may occur in the late stage. 60% of astrocytomas in the cerebral hemisphere have symptoms of epilepsy, while cerebellar astrocytoma has earlier symptoms of increased intracranial pressure caused by obstructive hydrocephalus.

Prognosis of pediatric astrocytoma

After total or partial resection of cerebellar astrocytoma plus radiotherapy, the 5-year survival rate is about 70% to 90%, and it has been reported to reach 100%. Tumor recurrence is the most important factor affecting its prognosis, and recurrence is closely related to the degree of surgical resection. Ilgren reports a 35% recurrence rate within 5 years for those who have not undergone radiotherapy after partial resection. 158 cases were followed up in this group, 68.4% of them survived for more than 5 years, and the long-term effect was good.

Pathogenesis of Pediatric Astrocytoma

The tumors were mostly located in the cerebellar hemisphere (56.6%), followed by the vermiform (20.4%) and the fourth ventricle (19.5%), and a few were located in the pontine cerebellum (3.5%). Cystic degeneration of tumor is a significant feature, accounting for about 55.4% to 82% of cerebellar astrocytoma. Cystic degeneration can manifest two types: one is "the sac is in the tumor", that is, the tumor is composed of single or multiple rooms The cyst wall is tumor tissue with unclear boundaries. The other is "tumor in the sac", that is, the tumor is a mural tumor nodule in a large cyst, while the remaining cyst wall is a glial hyperplasia zone instead of tumor tissue. The cystic fluid is mostly a yellow clear solution, about 20 to 40 ml, with high protein content and self-coagulation in vitro (Froin sign positive). Tumors rarely have necrosis and bleeding, and some lesions can be calcified. Cerebellar astrocytoma is mostly composed of well-differentiated fibrous astrocytic cells, but there are also no hairy cell astrocytomas. Cerebellar hair cell-type astrocytoma is not as morphologically obvious as similar tumors in the funnel area, and most of the tumor cells are spindle-shaped. It is a pathological feature of cerebellar astrocytoma that it is rich in collagen fibers and the collagen fibers are thickened or changed in clumps.

Astrocytomas include three subtypes:

1. Fiber type is a common type. There are glial fibers in the tumor. This is the main difference from the original plasma type. The texture of the tumor is tough. The cross section of the diffuse fiber type is white, which is not easy to distinguish from the white matter of the brain. The adjacent cortex is often infiltrated by the tumor, the color becomes darker, and the boundary with the white matter is blurred. The tumor center may have cystic changes. Focal fibrous border trimming is mainly found in the cerebellum, often with cystic changes. There are glial fibers in the stroma under the microscope, which are intersected between tumor cells, which are fibrous stellate cells.

2. Pure pulp type is the rarest type. The cut surface is translucent and uniform jelly-like, with deep invasion of white matter, unclear borders, and often degeneration, forming cysts. Under the microscope, the tumor consists of protoplasmic stellate cells.

3. Obese astrocytic tumors grow faster, accounting for about 1/4 of astrocytomas, and only occur in the hemisphere of the brain. The tumor is gray-red, the cut surface is uniform, soft, and infiltrative, but the naked eye can See tumor boundary, small cysts may be formed inside the tumor. Typical obese cells can be seen under the microscope. According to Kernohan classification, the malignancy of astrocytoma is grade .