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Registration Number

0217U000136, 0113U007715 , R & D reports

Title

To study the diagnostic markers and individualized criteria for complex treatment of intracranial hormonactiviti of the meningiomas

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Head

Zozulia Yuriy,

Registration Date

20-01-2017

Organization

SI "Institute of Neurosurgery named after Romodanov A.P. NAMS of Ukraine "

Description

The meningiomas is heterogeneous group of tumors. This tumors is differed in their clinical symptoms, indications for different methods and types of surgical and combined treatment, the frequency of postoperative complications, the biological structure and timing of recurrence. Surgical removal of the meningiomas is principal method of treatment. The problem of surgical stage's treatment of meningiomas is removal of the tumor as possible, taking into account: the localization of the tumor and the direction and the nature of its distribution; meningiomas relations with neurovascular structures, the intensity and the primary source of blood supply to meningiomas; general condition of the patient and the metabolic syndrome. If unable to complete resection, after subtotal or partial removal of it, it is advisable to combination therapy, surgical treatment is complemented by pathogenetic hormonalis therapy, and when it is not effectively is appointmented radiotherapy. The methods of diagnosis include histopathological study of the definition of ER levels, RR and Ki-67, which are characterizing histobiological features meningiomas: objectification of the need for additional hormonal treatment, the need for the appointment of adjuvant methods and forecast future trends (the probability of relapse). The presence of intensive expression of ER and PR in the meningiomas evidences suggests favorable outcome of the disease, while the absence of expression of steroid hormone indicates the worst prognosis because the potential signs of low differentiation cell neoplasms and the risk of rapid recurrence. The meningiomas differ in morphogenesis, which correlates with the levels of dysfunction of the hypothalamic-gonadal system. Relatively isolated pathogenetic variants of the disease - the central (hypothalamic-pituitary), gonadal and the shell (primary lesion firm brain cover, usually with anaplastic meningiomas or radiotherapy). Pathogenetic variants inherent distinctive clinical, hormonal and morphological characteristics. Analysis of long-term results of treatment of patients meningiomas showed that despite positive ER and PR, 30% - 60% of the tumor are not sensitive to the prescribed treatment and does not respond to the K-T, and 5% - 7% of the patients with negative receptor status meningiomas positively respond to the AG-T. The quality of life of patients depends on the radical removal of meningiomas: the condition of patients rather than after non-radical. After removing the non-radical meningiomas, treatment should complement the pathogenetic hormonal therapy or radiotherapy. A decrease in the incidence of postoperative recurrence in patients with meningiomas treated with AG-T, almost 1.8 times compared with those in which it was performed. Effectiveness depended on the degree of malignancy and sensitivity to the meningiomas AG-T. Appointment of AG-T in atypical meningiomas in the postoperative period has increased the 5-year survival from 75.5% to 90.0%. The average time of recurrence-free survival indicate the effectiveness of the K-T, as SBV increased from 34.66 months to 66 months (1.9 times), which confirms the efficiency of the developed diagnostic and treatment complex.

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І. В. Кручок
А. В. Булавка
В. В. Васлович
М. С. Кваша
О. Г. Черненко
О. Е Скобська
О. Ю. Чувашова
О.Я. Главацький
С. С. Макеєв
Т. А.Малишева
Ю. П. Зозуля