Kvasha M. Complex treatment of meningiomas of the brain based on their hormonal characteristics.

The dissertation presents a theoretical justification and new scientific solutions for neurosurgery actual scientific problem that is complex treatment of meningiomas of the brain based on their hormonal characteristics and role of neurosurgical stage of treatment. Materials of 1720 observations of patients with verified hystostructure MGM of supratentorial localization have been analyzed and katamnesis of 656 patients (5, 10 and 15 years after the initial surgery) has been studied. During the treatment of 1720 patients with MGM surgical treatment was used in 1282 (74,3%) patients, combination of surgical treatment with AG-T in 328 (19,1%) patients and combination of surgical treatment with PT was performed in 114 (6,6%) in order to prevent recurrence of MGM of various locations. Based on the comprehensive clinical neurological, hysto-biological, neurovisual, neurophysiological, biochemical, hormonal and immunohystochemical studies of patients with supratentorial tumors it was found that MGM are presented by the following pathogenic variants: by hystobiological features hormone sensitive or hormone resistant MGM, and by localization there are three main topographic anatomical variations (BM, KM and PM). The neurosurgical accesses and extent of interventions were modified based on topographic anatomical and molecular characteristics of MGM. A high correlation between the levels of steroid hormones in the blood of patients with MGM and RP - RE and proliferative activity in tumor tissue was proved. Based on the definition of relevant hystobiological indicators of MGM individual schemes of AH-T complex treatment of MGM were designed to improve postoperative quality of life, correction of hormonal - metabolic homeostasis and subsequent prediction and prevention of recurrence. The recommendations for optimal selection of adequate differentiated types of surgical and hormonal treatment depending on the factors that characterize the state of the patient and tumor hystobiological characteristics were substantiated.