Outcome After Surgical Treatments
- Total resection curative: Cure is expected in the majority of children who are operated early in the disease process, especially when the tumor diameter is less than 3 cm.
- Subtotal resection: Surgery may need to stop short of complete resection when there is extensive disease or excessive bleeding.
Outcome After Nonsurgical Treatments
Other treatment options include medications and radiosurgery therapy.
- Rapamycin: A modest response to rapamycin has been documented, but further clinical trials are needed to address the outcome.
- Everolimus: A phase II trial using everolimus, another mTor inhibitor used as an anti-organ rejection drug, to treat SEGAs in 28 patients with TSC showed SEGA reduction of at least 30% in 21 patients (75%) and at least 50% in 9 patients (32%) (19).
- mTOR agents inhibit growth but don’t cure: There is clear evidence that SEGAs grow back after the mTOR inhibitor is stopped (11). Most experts currently recommend continuation of mTOR inhibitors at the lowest efficacious dose.