PMID- 26706014
OWN - NLM
STAT- MEDLINE
DCOM- 20160922
LR  - 20151226
IS  - 1558-0776 (Electronic)
IS  - 1071-9091 (Linking)
VI  - 22
IP  - 4
DP  - 2015 Dec
TI  - Natural History and Current Treatment Options for Subependymal Giant Cell 
      Astrocytoma in Tuberous Sclerosis Complex.
PG  - 274-81
LID - S1071-9091(15)00070-4 [pii]
LID - 10.1016/j.spen.2015.10.003 [doi]
AB  - Subependymal giant cell astrocytoma (SEGA) is a benign brain tumor associated 
      with tuberous sclerosis complex (TSC). Since there were some discrepancies in 
      SEGA classification, in 2012, a consensus statement defined SEGA as a lesion at 
      the caudothalamic groove with either a size of more than 1cm in any direction or 
      a subependymal lesion at any location that has shown serial growth on consecutive 
      imaging regardless of size. This pointed that the documented tumor growing is an 
      important diagnostic feature. Currently, there are 2 therapeutic options: 
      surgical and medical with mammalian target of rapamycin (mTOR) inhibitors. 
      Neurosurgery should consider a localization and size of the tumor, presence of 
      hydrocephalus and surgeon's experience. Patients who are not qualified for 
      surgery and require therapeutic intervention are subjected to mTOR inhibitors 
      therapy. Everolimus, one of the mTOR inhibitors, has been recently approved in 
      the US and Europe for treatment of patients with TSC and SEGA. Treatment with 
      everolimus results in a rapid initial reduction in tumor volume, followed by a 
      phase of slower reduction or stabilization of residual mass. mTOR inhibitor dose 
      de-escalation strategy seems to be also logical in long-term SEGA treatment to 
      reduce the risk of adverse effects while maintaining the therapeutic effect. 
      However, duration of the treatment and the efficacy of dose reduction are still 
      questionable. Thus, this review covers the various approaches that are currently 
      being made toward improving the outcome of management of SEGA among patients with 
      TSC.
CI  - Copyright (c) 2015 Elsevier Inc. All rights reserved.
FAU - Jozwiak, Sergiusz
AU  - Jozwiak S
AD  - Department of Pediatric Neurology, Medical University of Warsaw, Warsaw, Poland. 
      Electronic address: sergiusz.jozwiak@gmail.com.
FAU - Mandera, Marek
AU  - Mandera M
AD  - Department of Pediatric Neurosurgery, Medical University of Silesia, Katowice, 
      Poland.
FAU - Mlynarski, Wojciech
AU  - Mlynarski W
AD  - Department of Pediatrics, Oncology, Hematology, and Diabetology, Medical 
      University of Lodz, Lodz, Poland.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20151021
PL  - United States
TA  - Semin Pediatr Neurol
JT  - Seminars in pediatric neurology
JID - 9441351
SB  - IM
MH  - Astrocytoma/diagnosis/*drug therapy/pathology/*surgery
MH  - Brain Neoplasms/diagnosis/*drug therapy/pathology/*surgery
MH  - Humans
MH  - Tuberous Sclerosis/diagnosis/*drug therapy/pathology/*surgery
EDAT- 2015/12/27 06:00
MHDA- 2016/09/23 06:00
CRDT- 2015/12/27 06:00
PHST- 2015/12/27 06:00 [entrez]
PHST- 2015/12/27 06:00 [pubmed]
PHST- 2016/09/23 06:00 [medline]
AID - S1071-9091(15)00070-4 [pii]
AID - 10.1016/j.spen.2015.10.003 [doi]
PST - ppublish
SO  - Semin Pediatr Neurol. 2015 Dec;22(4):274-81. doi: 10.1016/j.spen.2015.10.003. 
      Epub 2015 Oct 21.