Avtor/Urednik		Petrič-Grabnar, Gabrijela
Naslov		Radioterapija možganskih tumorjev otrok
Prevedeni naslov		Radiotherapy for pediatric brain tumors
Tip		članek
Vir		Med Razgl
Vol. in št.		Letnik 37, št. Suppl 4
Leto izdaje		1998
Obseg		str. 179-84
Jezik		slo
Abstrakt		Today, over a half of children with brain tumors are expected to survive to adulthood. In radiotherapy for brain tumors, the irradiated volume always includes a proportion of healthy tissue, thus entailing a risk of not only acute but also late sequelae of treatment *e. g. disorders in soft tissue and hone growth, neurocognitive development dis- orders, endocrine gland dysfunction*, as well as the appearence of secondary tumors. The risk of RT-related late seyuelae is higher in children up to 3 years of age, because of incomplete myelinization process. Therefore, in the selection of treatment method, the possibility of cure should always be weighed against the possible treatment-related toxicity. Children with low-grade gliomas are treated with irra- diation in the case of extensive postoperative resid- ua1 disease, or when surgery is not feasihle due to unfavorable tumor site (brain stem, hypothalamus, optic pathway tumors). RT is further indicated in children with evidence of tumor recurrence on a fol- low-up, although they may be Eree of any clinical symptoms. The irradiated volume comprises the tumor as imaged on CT scan or MRI with a 2 cm safe- ty margin of healthy tissue; the therapeutic dose in children over 3 years of age is 54 Gy given in daily fractions of 1.5 to 1.8 Gy. Children under 3 years of age are treated by chemotherapy *ChT* while RT is postponed. The same treatment approach is also used in children with gliomas of high-grade malignancy and those with low-grade supratentorial ependymomas. Abstract truncated at 2000 characters.
Izvleček		Več kot polovica otrok z možganskimi tumorji ima danes pričakovano dolgo preživetje. Pri zdravljenju možganskih tumorjev z obsevanjem /RT) je v obsevani prostornini vedno tudi del zdravih tkiv, zato obstajata možnost akutnih kot tudi nereverzibilnih poznejših posledic, motena rast mehkih tkiv in kosti, moten nevrokognitivni razvoj, moteno delovanje žlez z notranjim izločanjem in možnost nastanka sekundarnega tumorja. Večja verjetnost poznejših posledic po RT je pxi otrocih do tretjega leta starosti, ko mielinizacija še ni zakljućena. Pri izbiri metod zdravljenja je vedno potrebno pretehtati možen uspeh ozdravitve in toksičnost zdravljenja. Otroke z nizkomalignimi gliomi zdravimo z obsevanjem, če je po operaciji ostal velik del bolezenskega procesa ali operacija zaradi neugodne lege ni bila možna (možgansko deblo, hipotalamus, vidni živec). RT je priporočena pri otrocih, katerim ob sledenju ugotovimo ponovno rast tumorja, četudi simptomov bolezni ni. Obsevana prostornina obsega tumor, ki je viden s slikanjem z računalniško tomografijo (CT) ali magnetno resonanco (MR), in 2 cm varnostnega roba zdravega tkiva. Pxi otrocih, stareših od treh let, je terapevtska doza 54 Gy v dnevnih odmerkih 1,5 do 1,8 Gy. Otroke, ki so mlajši od 3 let, zdravimo s ke- moterapijo (KT) in RT odložimo. Abstract truncated at 2000 characters.
Deskriptorji		BRAIN NEOPLASMS CHILD RADIOTHERAPY GLIOMA MEDULLOBLASTOMA