Treatment of low-grade cerebral astrocytoma: new methods and evaluation of results.

Seventeen patients with low-grade cerebral gliomas, fourteen of them low-grade astrocytomas, were operated using CT/ultrasound-guided operative technique. The mean age of the patients was 34 years, and the mean follow-up time 13 months. The patients usually presented with symptoms of headache and/or epilepsy. Craniotomy was performed, and all lesions could be visualized as hyperechogenic masses using intraoperative ultrasound imaging. This paper describes the preliminary results of treatment with conventional resection methods, and discusses methods which could be readily adapted to the CT/ultrasound-based imaging system: CO2 and Nd-YAG laser, ultrasound aspirator, intense focused ultrasound lesioning and immunotherapy with monoclonal antibodies. Finally the evaluation of treatment results with quality of life studies is suggested, especially for longitudinal follow-up of patients treated with alternative therapeutic methods. The role of quality of life studies is particularly important in assuring the longest and most useful survival of patients with small low-grade cerebral tumors.