Antineoplastic agents such as Vincristine, cisplatin and Lomustine act by inhibiting the key factors responsible for neoplastic transformation of cells. Analog of cisplatin used in treatment regimens for relapse. Lomustine inhibits RNA and DNA synthesis through alkylation of DNA and carbamylation of DNA polymerase, and alteration of RNA, enzymes, and proteins. Corticosteroids such as Prednisone have anti-inflammatory properties and cause profound and varied metabolic effects. They modify the body's immune response to diverse stimuli.
Antihistamines such as Diphenhydramine may control itching by blocking effects of endogenously released histamine.
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Treatment of symptomatic tumours is as follows:
- Surgical resection represents the most common approach to clinically significant lesions
- Rarely, radiation and/or chemotherapy may be recommended to treat disabling ependymomas
- Palliative chemotherapy for surgically unresectable ependymomas may be attempted with lomustine, vincristine, and prednisone, or carboplatin and vincristine, following radiation therapy
- Erlotinib has shown promise in the treatment of unresectable, progressive vestibular schwannomas
Tumor resection and radiotherapy
- For small vestibular schwannomas, surgical resection and stereotactic radiosurgery may preserve hearing and facial nerve function in selected patients
- Larger tumors may require surgical resection despite irreversible hearing loss
- A debulking procedure may result in preservation of hearing or, at the minimum, prolongation of auditory decompensation
- Nonvestibular cranial nerve schwannomas may be treated effectively with a combination of microsurgery and radiosurgery
Intracranial meningiomas may be quite slow growing; surgical resection should be considered only when such lesions are causing serious, disabling symptoms.
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