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Treatment department: Department of Brain Surgery Oncology Treatment cost: about 10,000--30000 in the city's top three hospitals Cure rate: Treatment period: Treatment method: Surgery, radiotherapy General treatment of posterior fossa ependymoma
Surgical resection is the preferred treatment. Because tumors often adhere to the brainstem and posterior cranial nerves, the rate of total surgical resection is reduced. Strengthening intraoperative neuroelectrophysiological monitoring will help more completely remove the tumor and reduce postoperative complications and mortality. For the tumor that grows from the bottom of the fourth ventricle, it is not necessary to force a full cut. A thin layer of tumor tissue can remain on the bottom of the fourth ventricle to avoid damage to the thalamus and brainstem, but the operation must restore the cerebrospinal fluid obstruction. Ependymoma is moderately sensitive to radiotherapy, and radiotherapy should be applied to residual tumors and the whole brain and spinal canal. Moreover, in order to prevent the occurrence of implantation and metastasis outside the primary focus, preventive whole brain and spinal cord radiotherapy should also be performed for non-metastatic anaplastic tumors. Ependymoma is less sensitive to chemotherapy than medulloblastoma, and high-dose chemotherapy cannot produce significant effects. However, some scholars believe that chemotherapy can inhibit the proliferation of residual tumors, which can easily be stripped from the brain stem and cranial nerves during the second operation.
The prognosis of this disease is poor, especially in children. The main factors affecting the prognosis are: the age of the patient, the location of the tumor, the degree of surgical resection, the pathological type of the tumor, postoperative radiotherapy and chemotherapy, etc. Among them, the degree of surgical resection is more important. In 1995, Pollack reported that the 5-year recurrence-free survival (PFS) in the total tumor resection group was 75% to 80%, while the subtotal resection group was only 35%. The 1-year survival rate in this group was 42.7%, and the 5-year survival rate was 16.1%. The cause of death was increased intracranial pressure after local recurrence.
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