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我老人家终于又爬上来了

我老人家终于又爬上来了# Heart - 心情好么？

D*a2010-08-07 07:08

1 楼

发小的爸爸得了脑胶质母瘤，恶性的，发展很快。但国内没有什么有效的治疗办法，现
在非常着急。如果美国能有更先进的治疗办法，他希望带爸爸来美国看病。
请教万能的medicine版，美国有什么有效治疗办法吗？任何相关信息对他们都会有很大
帮助的。跪谢各位业内人士的建议，万分感谢！

w*y2010-08-07 07:08

2 楼

刚刚在精华贴没找到，所以发贴问问大家
公司律师在和我商量申请绿卡的事情（H1B -> EB2），另一方面今年10月份左右我想邀
请爸爸妈妈过来旅游玩玩（快2年没有回去了，尽尽孝心），不知道两者之间会不会有
影响。可能自己想太多，不过反正排期要5年，不急在这几个月，希望爸妈签证顺利些
。请教一下大家，谢谢：）

w*u2010-08-07 07:08

3 楼

我的飞机11am到北京，不知道还能不能赶上下午比较晚的场次呢
如果到下午5点签证官还没有约完，他们不会直接让我们以后再来吧？
thanks.

o*t2010-08-07 07:08

4 楼

☆─────────────────────────────────────☆
Guyver (凯普) 于 (Sun Sep 11 16:11:41 2011, 美东) 提到:
对中秋节其实没太多情节，除了吃点月饼，一家吃个饭而已，不过已经记不得有多久没
和家里一起过中秋了，呵呵~
祝大家有家人在身边的一起过个开心的中秋节，自己一个人的就找朋友一起吃饭好了：）
20个包子，恩，小菩提说过：凯普只在发包子时候出现.哈哈!
☆─────────────────────────────────────☆
Dwayna (慢性子) 于 (Sun Sep 11 16:35:39 2011, 美东) 提到:
re,中秋跟家人远在天边啊
☆─────────────────────────────────────☆
chongchong1 (虫虫) 于 (Sun Sep 11 16:58:18 2011, 美东) 提到:
吃包子
中秋快乐

：）
☆─────────────────────────────────────☆
wldft (dft) 于 (Sun Sep 11 18:11:05 2011, 美东) 提到:
中秋快乐
☆─────────────────────────────────────☆
qingerer (东晴西雨) 于 (Sun Sep 11 18:19:42 2011, 美东) 提到:
中秋快乐，谢包子。
☆─────────────────────────────────────☆
superguava (加勒比野猪) 于 (Sun Sep 11 18:42:22 2011, 美东) 提到:
发月饼吧
☆─────────────────────────────────────☆
marcat (猫姐) 于 (Sun Sep 11 18:47:13 2011, 美东) 提到:
中秋快乐:)
月饼还得冰皮的。
☆─────────────────────────────────────☆
hwlv (瓢虫-不是七星的~~) 于 (Sun Sep 11 18:51:52 2011, 美东) 提到:
中秋快乐啊!
☆─────────────────────────────────────☆
onearcat (嘟嘟喵) 于 (Sun Sep 11 19:31:42 2011, 美东) 提到:
中秋节快乐
俺们家兄妹有十多年没聚一起了.... 想想时间过去真是快
☆─────────────────────────────────────☆
ADOMET8 (杉木) 于 (Sun Sep 11 19:39:43 2011, 美东) 提到:
月是故乡明祝大家中秋快乐～～
：）
☆─────────────────────────────────────☆
woa (woa) 于 (Sun Sep 11 20:52:46 2011, 美东) 提到:
同乐。
：）
☆─────────────────────────────────────☆
verithas (非猫女王) 于 (Sun Sep 11 20:59:37 2011, 美东) 提到:
包子来了？
☆─────────────────────────────────────☆
wxn03 (Songp宋平) 于 (Sun Sep 11 21:11:10 2011, 美东) 提到:
re
☆─────────────────────────────────────☆
santorini (103/7) 于 (Sun Sep 11 21:13:57 2011, 美东) 提到:
中秋快乐
☆─────────────────────────────────────☆
IED (TNT) 于 (Sun Sep 11 21:18:54 2011, 美东) 提到:
re
☆─────────────────────────────────────☆
Vagrant007 (meinv) 于 (Sun Sep 11 21:19:42 2011, 美东) 提到:
中秋快乐啊
☆─────────────────────────────────────☆
yearly (粘粘) 于 (Sun Sep 11 21:22:18 2011, 美东) 提到:
re
☆─────────────────────────────────────☆
LittleSeven ( 蜜果小七) 于 (Sun Sep 11 21:34:23 2011, 美东) 提到:
RE
☆─────────────────────────────────────☆
alcest (TOUGHTOUGH) 于 (Sun Sep 11 22:24:54 2011, 美东) 提到:
i love you all pretty girls on this board
☆─────────────────────────────────────☆
westview2011 (west view) 于 (Sun Sep 11 22:42:02 2011, 美东) 提到:
中秋快乐
：）
☆─────────────────────────────────────☆
xrym (~嘻嘻熊~) 于 (Sun Sep 11 23:05:48 2011, 美东) 提到:
rerere
☆─────────────────────────────────────☆
xiaoputi (小菩提) 于 (Sun Sep 11 23:14:49 2011, 美东) 提到:
恩，关键时候你就大侠般的现身了。呵呵
中秋快乐，冰皮月饼吃一个
：）
☆─────────────────────────────────────☆
jjl231 (晶晶梨) 于 (Sun Sep 11 23:53:10 2011, 美东) 提到:
中秋快乐～
：）
☆─────────────────────────────────────☆
ylonglew (小龙包子) 于 (Mon Sep 12 01:03:48 2011, 美东) 提到:
吃包子
中秋快乐
☆─────────────────────────────────────☆
carlx (暴躁男) 于 (Mon Sep 12 01:11:33 2011, 美东) 提到:
re
☆─────────────────────────────────────☆
FatSheep (Serta is my cousin) 于 (Mon Sep 12 01:41:06 2011, 美东) 提到:
re
☆─────────────────────────────────────☆
WMTT (舞墨倜傥) 于 (Mon Sep 12 01:57:26 2011, 美东) 提到:
热
☆─────────────────────────────────────☆
CurlCurl (CurlCurl) 于 (Mon Sep 12 02:02:53 2011, 美东) 提到:
RE
☆─────────────────────────────────────☆
cyyxx76 (天使爱宓里) 于 (Mon Sep 12 08:10:21 2011, 美东) 提到:
中秋快乐！
☆─────────────────────────────────────☆
S445320 (E-Star) 于 (Mon Sep 12 08:33:14 2011, 美东) 提到:
中秋快乐！
☆─────────────────────────────────────☆
scmm (乐儿妈) 于 (Mon Sep 12 08:41:55 2011, 美东) 提到:
中秋快乐！
☆─────────────────────────────────────☆
sweetie69 (东奔西跑) 于 (Mon Sep 12 09:01:01 2011, 美东) 提到:
再小也是包子呀。
☆─────────────────────────────────────☆
maisui (麦穗) 于 (Mon Sep 12 09:27:41 2011, 美东) 提到:
：）
节日快乐
☆─────────────────────────────────────☆
devilinred (Devil In Red) 于 (Mon Sep 12 09:28:00 2011, 美东) 提到:
节日快乐
☆─────────────────────────────────────☆
Guyver (凯普) 于 (Mon Sep 12 10:19:30 2011, 美东) 提到:
包子发到34楼，谢谢大家！
☆─────────────────────────────────────☆
UNO (红衫会之紅小豩) 于 (Mon Sep 12 10:58:37 2011, 美东) 提到:
福乐
☆─────────────────────────────────────☆
DragonPig (小龙) 于 (Mon Sep 12 12:02:05 2011, 美东) 提到:
唉，又没赶上，中秋快乐ANYWAY
☆─────────────────────────────────────☆
mgbm (天使) 于 (Mon Sep 12 12:04:58 2011, 美东) 提到:
再吃。good　luck
☆─────────────────────────────────────☆
littledevil (devil) 于 (Mon Sep 12 12:05:46 2011, 美东) 提到:
pai....
：）
☆─────────────────────────────────────☆
fmvector (vector) 于 (Mon Sep 12 12:18:01 2011, 美东) 提到:
chi.中秋快乐!
☆─────────────────────────────────────☆
yunchung (yunchung) 于 (Mon Sep 12 12:43:01 2011, 美东) 提到:
中秋快乐
吃包子
☆─────────────────────────────────────☆
walkingtall (步步高) 于 (Mon Sep 12 12:50:12 2011, 美东) 提到:
啖
：）
☆─────────────────────────────────────☆
onearcat (嘟嘟喵) 于 (Mon Sep 12 13:05:50 2011, 美东) 提到:
后来的俺帮你补上吧～
大过节的吃月饼就吃个痛快................
☆─────────────────────────────────────☆
USSTang (SS-306) 于 (Mon Sep 12 13:13:05 2011, 美东) 提到:
中秋快乐，阖家团圆！
☆─────────────────────────────────────☆
lxinzheng (头发2mm长) 于 (Mon Sep 12 13:48:42 2011, 美东) 提到:
中秋快乐！
☆─────────────────────────────────────☆
wasabee (wasabee) 于 (Mon Sep 12 14:18:37 2011, 美东) 提到:
中秋快乐CHI
：）
☆─────────────────────────────────────☆
iSerenity (iS) 于 (Mon Sep 12 14:24:12 2011, 美东) 提到:
谢谢月饼，过节快乐！
后来的俺帮你补上吧～
大过节的吃月饼就吃个痛快................
☆─────────────────────────────────────☆
yizhitumao () 于 (Mon Sep 12 14:56:44 2011, 美东) 提到:
中秋快乐
☆─────────────────────────────────────☆
routing (梦云-- tiki) 于 (Mon Sep 12 16:07:41 2011, 美东) 提到:
中秋快乐团团圆圆
：）
☆─────────────────────────────────────☆
watercrane (鹤) 于 (Mon Sep 12 16:24:19 2011, 美东) 提到:
re
☆─────────────────────────────────────☆
nn2 (zt) 于 (Mon Sep 12 16:29:06 2011, 美东) 提到:
节日快乐
：）
☆─────────────────────────────────────☆
icaruschina (伊卡) 于 (Mon Sep 12 16:45:05 2011, 美东) 提到:
哇呀，好久不见！
中秋快乐！
☆─────────────────────────────────────☆
shaya (小胖) 于 (Mon Sep 12 21:00:47 2011, 美东) 提到:
中秋团圆
：）
☆─────────────────────────────────────☆
watercrane (鹤) 于 (Mon Sep 12 22:00:21 2011, 美东) 提到:
re

a*n2010-08-07 07:08

5 楼

Mark一个

a*22010-08-07 07:08

6 楼

If it is Glioblastoma, then this is the worst brain tumor. It tends to
develop very fast and spread to the opposite side very early. Treatment is
surgery plus adjuvant therapy (radiation therapy and chemo). Early surgery
is very very important. You need to find a very good hospital who has
extensive experience on this kind of tumor. (I saw a patient with GBM who
did two surgeries 10 years ago at the beginning and then several years ago
after it recurred. Now she is under palliative care because it is really end
stage now. We all think it's a miracle and the patient is a fighter.
Usually GBM patients die very soon after getting diagnosed)
The prognosis depends on many factors, like onset age, mental status, early
steroids use, and some scores I forgot. But in general, the prognosis is
dismal (more than just poor).
As for coming to the US, I don't think it's necessary. First, this is the
kind of surgery that is earlier is better. So no time to wait. To come here,
you have to find the right neurosurgeon, and wait for the operation
schedule. Second, it's questionable whether patient will tolerate the long
distance flight. Third, I believe adjuvant radiation and chemo therapy will
have no difference between China and US. So really no need to come to the US
. Find a decent hospital and experienced neurosurgeon in China as early as
possible and do it NOW!
Good luck!

T*o2010-08-07 07:08

7 楼

绿卡持有者父母签过的很多～

s*h2010-08-07 07:08

8 楼

吃了没？

【在 a*****n 的大作中提到】

: Mark一个

l*h2010-08-07 07:08

9 楼

did I miss something? if you say 脑胶质母瘤, this means surgery has already
been done. it is diagnosed by pathology. conclusion section of MRI report
should read something like "consistent with HGG in xxx area, GBM likely." or
sometimes "consistent with GBM." depending on how good the radiologist is,
the accuracy can be as high as 95%, it can also be much lower.
in most brain areas, when HGG is suspected, the only biopsy type is open
biopsy, that is, you open up the field, take a few pieces of sample for
frozen, in 30-60 minutes you get preliminary results back and then,
depending on the results, proceed with a resection or close up, or whatever
is suitable. that's the reason if you have a diagnosis of 脑胶质母瘤, you
tell people the surgery has been done.
suspected HGG, in most brain areas, are deemed moderately urgent, that is, a
surgery is usually arranged in 1-2 weeks. there are plenty of brain tumors
treated with much higher urgency.
before Christmas, we had a patient with typical GBM clinical features: mid-
50s white male, sudden symptom onset including seizures, irregular shape on
MRI, frontal lobe, >5cm, hyperintense and uneven signal on T2-weighted,
diffuse border, uneven enhancement on T1 with and multiple remote
enhancement.
the patient and family was prepared for the worst scenario. it turned out to
be a pilocytic. the best Christmas gift to the patient and family.

【在 D*****a 的大作中提到】

: 发小的爸爸得了脑胶质母瘤，恶性的，发展很快。但国内没有什么有效的治疗办法，现
: 在非常着急。如果美国能有更先进的治疗办法，他希望带爸爸来美国看病。
: 请教万能的medicine版，美国有什么有效治疗办法吗？任何相关信息对他们都会有很大
: 帮助的。跪谢各位业内人士的建议，万分感谢！

m*92010-08-07 07:08

10 楼

你申请绿卡只要你出境不用AP,还是H1身份，对父母签证没啥影响，但是至于你两年没
回过国就不知道有没有影响了

Y*e2010-08-07 07:08

11 楼

从哪里翻墙过来？

【在 a*****n 的大作中提到】

: Mark一个

a*22010-08-07 07:08

12 楼

already
or
,
whatever
That is a very interesting case. I even thought the patient I mentioned
earlier was misdiagnosed as GBM considering she survived at least 10 years,
which is totally a miracle. In your case, the MRI is so consistent with GBM,
so clinical presentations are really unreliable in many patients.

【在 l*h 的大作中提到】

: did I miss something? if you say 脑胶质母瘤, this means surgery has already
: been done. it is diagnosed by pathology. conclusion section of MRI report
: should read something like "consistent with HGG in xxx area, GBM likely." or
: sometimes "consistent with GBM." depending on how good the radiologist is,
: the accuracy can be as high as 95%, it can also be much lower.
: in most brain areas, when HGG is suspected, the only biopsy type is open
: biopsy, that is, you open up the field, take a few pieces of sample for
: frozen, in 30-60 minutes you get preliminary results back and then,
: depending on the results, proceed with a resection or close up, or whatever
: is suitable. that's the reason if you have a diagnosis of 脑胶质母瘤, you

c*t2010-08-07 07:08

13 楼

我现在是485交上去2年了，去年也用AP回过国。
现在要申请父母来探亲，需要出什么材料呢？
我用AP入境的stamp， I94，还需要485的notice吗？
多谢了。
H1B刚过期，公司忘了给Renew了。
要不然还可以用H1B邀请。

【在 w********y 的大作中提到】

: 刚刚在精华贴没找到，所以发贴问问大家
: 公司律师在和我商量申请绿卡的事情（H1B -> EB2），另一方面今年10月份左右我想邀
: 请爸爸妈妈过来旅游玩玩（快2年没有回去了，尽尽孝心），不知道两者之间会不会有
: 影响。可能自己想太多，不过反正排期要5年，不急在这几个月，希望爸妈签证顺利些
: 。请教一下大家，谢谢：）

w*l2010-08-07 07:08

14 楼

惊见故人

【在 Y*********e 的大作中提到】

: 从哪里翻墙过来？

l*h2010-08-07 07:08

15 楼

every one was surprised. the senior pathologist said it was not the first
but very very rare. pilocytic astro, you'd expect most are in young adults
and children, even though it can occur anywhere, most are in infratentorial
compartment (mainly cerebellum), you'd expect cystic changes, with ring
enhancement on T1 with.
much more often, anaplastic astro/oligo cannot be well differentiated from
gbm on mri.

,
GBM,

【在 a**********2 的大作中提到】

:
: already
: or
: ,
: whatever
: That is a very interesting case. I even thought the patient I mentioned
: earlier was misdiagnosed as GBM considering she survived at least 10 years,
: which is totally a miracle. In your case, the MRI is so consistent with GBM,
: so clinical presentations are really unreliable in many patients.

a*n2010-08-07 07:08

16 楼

没，你给啊：）

【在 s******h 的大作中提到】

: 吃了没？

D*a2010-08-07 07:08

17 楼

非常感谢！他的爸爸刚做了开颅活检，医生认为是脑胶质母瘤。老人今年65岁，现在
体重下降很快，走路腿脚不灵便。
也就是说，现在他们应该在国内找最好的医生尽快手术切除，然后再做放化辽是吗？
老人的MRI结果能看到至少4个瘤，这是属于早期还是晚期？还能手术吗？
万分感谢！

is
end
early

【在 a**********2 的大作中提到】

: If it is Glioblastoma, then this is the worst brain tumor. It tends to
: develop very fast and spread to the opposite side very early. Treatment is
: surgery plus adjuvant therapy (radiation therapy and chemo). Early surgery
: is very very important. You need to find a very good hospital who has
: extensive experience on this kind of tumor. (I saw a patient with GBM who
: did two surgeries 10 years ago at the beginning and then several years ago
: after it recurred. Now she is under palliative care because it is really end
: stage now. We all think it's a miracle and the patient is a fighter.
: Usually GBM patients die very soon after getting diagnosed)
: The prognosis depends on many factors, like onset age, mental status, early

a*n2010-08-07 07:08

18 楼

老了，翻不动了

【在 Y*********e 的大作中提到】

: 从哪里翻墙过来？

D*a2010-08-07 07:08

19 楼

老人做了MRI和活检，可是活检的正式结果要等一个星期。主治医生根据现有的信息做
的判断是脑胶质母瘤。
神医的意思是检查结果有可能不准？手术的时候发现不是脑胶质母瘤？开颅切除手术是
不是应该在国内尽快做，美国的手术技术有比国内先进吗？
万分感谢！

already
or
,
whatever

【在 l*h 的大作中提到】

s*d2010-08-07 07:08

20 楼

在国内？

【在 a*****n 的大作中提到】

: Mark一个

a*22010-08-07 07:08

21 楼

I am not sure whether it's still surgical indicative. But definitely don't
come to the US. Both time and
his condition don't allow. Find a neurosurgeon now and get expertise opinion
NOW.

【在 D*****a 的大作中提到】

: 非常感谢！他的爸爸刚做了开颅活检，医生认为是脑胶质母瘤。老人今年65岁，现在
: 体重下降很快，走路腿脚不灵便。
: 也就是说，现在他们应该在国内找最好的医生尽快手术切除，然后再做放化辽是吗？
: 老人的MRI结果能看到至少4个瘤，这是属于早期还是晚期？还能手术吗？
: 万分感谢！
:
: is
: end
: early

a*n2010-08-07 07:08

22 楼

Nope. In bed now

【在 s********d 的大作中提到】

: 在国内？

a*22010-08-07 07:08

23 楼

His age and biopsy consistent with glioblastoma. The chance of misdiagnosis
is extremely low. So better not have false hope and early surgery is the
key if possible. If no surgery indication, then radiation therapy for
symptom relief and then palliative care. Absolutely not come to the US.

【在 D*****a 的大作中提到】

j*j2010-08-07 07:08

24 楼

怎么没人再喊你八戒了。

【在 a*****n 的大作中提到】

: Mark一个

l*h2010-08-07 07:08

25 楼

what i was saying was that surgical resection, if possible, should be done
at the same time of open biopsy, unless the frozen sections were too
inclusive. but as long as a tumor can be determined from frozen and anatomy
allows, you usually do a subtotal resection in the same procedure of open
biopsy. the reason is that the subtotal resection will be the only surgery
in short term in many cases, in cases of hgg later confirmed by H-E, if a
subtotal is done, there will also be more time to prepare for a more radical
, extended resection.
frozen results should become available in 30-60 minutes. standard H-E 3 days
. pathological diagnosis of gbm doesn't require ihc, but ihc can be part of
the genetic testing which could be useful in estimating whether some novel
agents may be beneficial.
how extensive the resection should be in cases of HGG: this is the question.
this depends on the surgeon's understanding of individual pathological
types and the imaging techniques used in pre-op preparation.
without treatment, the median survival of adult supratentorial GBM is about
3 months. the median survival in the US and western Europe is better than 15
months now with surgical resection plus post-op radiation plus chemotherapy
(mainly based on either temozolomide or carmustine.). in those with
favorable MGMT status, with temozolomide treatment, the median survival is
better than 2 years with some groups achieving better than 3 years. EGFR-
based therapies are also useful in patients with those genetic features, but
they are not part of standard of care yet.
i would advise against coming to the US but rather go to somewhere in China
that has some research efforts on GBM, especially with the ability of
testing for MGMT status.

【在 D*****a 的大作中提到】

: 老人做了MRI和活检，可是活检的正式结果要等一个星期。主治医生根据现有的信息做
: 的判断是脑胶质母瘤。
: 神医的意思是检查结果有可能不准？手术的时候发现不是脑胶质母瘤？开颅切除手术是
: 不是应该在国内尽快做，美国的手术技术有比国内先进吗？
: 万分感谢！
:
: already
: or
: ,
: whatever

a*n2010-08-07 07:08

26 楼

什么时候有人这么叫过我？

【在 j***j 的大作中提到】

: 怎么没人再喊你八戒了。

l*h2010-08-07 07:08

27 楼

if gbm and multiple locations, and if the locations are not eloquent,
subtotal resection is usually attempted once (one time, no benefit to
repeating) to reduce tumor burden and improve quality of life (few seizures,
less headaches etc.) this may also extend survival for a few months.
but don't pin too much hope on an extended survival.
we usually don't say early stage or late stage in GBM. at the time of
diagnosis, the vast majority of GBM is at late stage according to criteria
used in other cancers.

【在 D*****a 的大作中提到】

s*h2010-08-07 07:08

28 楼

你说呢八戒

【在 a*****n 的大作中提到】

: 什么时候有人这么叫过我？

a*22010-08-07 07:08

29 楼

Wow, good to learn. A lot of information, even for me :)
Btw, are you a neurosurgeon or pathologist? Seems you know a lot about both.
I know very little about Pathology besides STEP1 :(

anatomy
radical
days
of

【在 l*h 的大作中提到】

: what i was saying was that surgical resection, if possible, should be done
: at the same time of open biopsy, unless the frozen sections were too
: inclusive. but as long as a tumor can be determined from frozen and anatomy
: allows, you usually do a subtotal resection in the same procedure of open
: biopsy. the reason is that the subtotal resection will be the only surgery
: in short term in many cases, in cases of hgg later confirmed by H-E, if a
: subtotal is done, there will also be more time to prepare for a more radical
: , extended resection.
: frozen results should become available in 30-60 minutes. standard H-E 3 days
: . pathological diagnosis of gbm doesn't require ihc, but ihc can be part of

j*j2010-08-07 07:08

30 楼

这么快就把cute忘了，
人好歹也跟前跟后的唤了你那么多年。。。哈哈
我说cute哪去了，点开伊的名字一看。。。哎，别是被气跑的吧，cft.

【在 a*****n 的大作中提到】

: 什么时候有人这么叫过我？

D*a2010-08-07 07:08

31 楼

非常感谢神医的回复！请问一般情况下，GBM发展到什么阶段以后就不适合手术了？我
发小现在很担心北京的医生做不了这个手术，把病情耽误了。

opinion

【在 a**********2 的大作中提到】

: I am not sure whether it's still surgical indicative. But definitely don't
: come to the US. Both time and
: his condition don't allow. Find a neurosurgeon now and get expertise opinion
: NOW.

j*j2010-08-07 07:08

32 楼

呵呵

【在 s******h 的大作中提到】

: 你说呢八戒

l*h2010-08-07 07:08

33 楼

the technical aspect of GBM resection, in most brain areas, is not hard.
see my previous reply, in this multiple location case, usually try once to
reduce tumor burden (subtotal resection, not total or extended resection).
not much more can be done surgically.

【在 D*****a 的大作中提到】

: 非常感谢神医的回复！请问一般情况下，GBM发展到什么阶段以后就不适合手术了？我
: 发小现在很担心北京的医生做不了这个手术，把病情耽误了。
:
: opinion

a*n2010-08-07 07:08

34 楼

你很关心cute嘛。。。

【在 j***j 的大作中提到】

: 这么快就把cute忘了，
: 人好歹也跟前跟后的唤了你那么多年。。。哈哈
: 我说cute哪去了，点开伊的名字一看。。。哎，别是被气跑的吧，cft.

a*22010-08-07 07:08

35 楼

This is a very specific question. I am not neurosurgeon, so I really can't
give you the answer. That's why I said find an experienced neurosurgeon and
do surgery as early as possible if it's surgically resectable. If the
answer is no, then palliative care with radiation therapy, I do not
recommend chemo though many may do so, because it just destroys the quality
of life. For a surgically non-resectable GBM, palliative care to make
patient comfortably live for the rest of his life is more humanistic and
cost effective.

【在 D*****a 的大作中提到】

a*n2010-08-07 07:08

36 楼

peng

【在 s******h 的大作中提到】

: 你说呢八戒

l*h2010-08-07 07:08

37 楼

what if I say I just Googled all the stuff?
i just published a book chapter on a certain group of gliomas in a
neurooncology textbook. but don't try to find my name. there are quite some
Chinese names in the field.

both.

【在 a**********2 的大作中提到】

: Wow, good to learn. A lot of information, even for me :)
: Btw, are you a neurosurgeon or pathologist? Seems you know a lot about both.
: I know very little about Pathology besides STEP1 :(
:
: anatomy
: radical
: days
: of

D*a2010-08-07 07:08

38 楼

非常感谢神医的回复！就是有些专业术语看不懂。神医能给解释一下这几个词是什么
意思吗？
MGMT status, temozolomide treatment, EGFR-based therapies。
谢谢！

anatomy

【在 l*h 的大作中提到】

l*h2010-08-07 07:08

39 楼

http://en.wikipedia.org/wiki/O-6-methylguanine-DNA_methyltransf
for the other, try to search for "egfr AND gbm"

【在 D*****a 的大作中提到】

: 非常感谢神医的回复！就是有些专业术语看不懂。神医能给解释一下这几个词是什么
: 意思吗？
: MGMT status, temozolomide treatment, EGFR-based therapies。
: 谢谢！
:
: anatomy

k*e2010-08-07 07:08

40 楼

听说天坛的脑外科还不错。不建议来美国治疗，时间和精力都不允许啊。

a*22010-08-07 07:08

41 楼

That's awesome... Congratulations! I guess you are pathologist?

some

【在 l*h 的大作中提到】

: what if I say I just Googled all the stuff?
: i just published a book chapter on a certain group of gliomas in a
: neurooncology textbook. but don't try to find my name. there are quite some
: Chinese names in the field.
:
: both.

a*22010-08-07 07:08

42 楼

I don't know those either,too specialized.

【在 D*****a 的大作中提到】

l*h2010-08-07 07:08

43 楼

i did a quick online search and didn't find any good patient education
material in Chinese (simplified or traditional) on this, except for one
sentence:
多發性膠質母細胞瘤內MGMT的promotor若被甲基化，則以Temozolomide治療的效果更佳
。

D*a2010-08-07 07:08

44 楼

谢谢！

【在 l*h 的大作中提到】

: i did a quick online search and didn't find any good patient education
: material in Chinese (simplified or traditional) on this, except for one
: sentence:
: 多發性膠質母細胞瘤內MGMT的promotor若被甲基化，則以Temozolomide治療的效果更佳
: 。

H*a2010-08-07 07:08

45 楼

我爸爸得的是gbm，生病前非常健康的一个人，20多年没有进过医院，从走路开始不稳
当，然后一边胳膊活动不便开始发现有问题，在天坛医院诊断和手术的。gbm发展起来
非常快，从完全行动自由到一边身体有行动障碍大概就2个月不到。手术前说瘤有5公分
左右，后来打开发现有将近7公分。天坛医院很难进，病人太多了，当时也是走了很多
的关系。手术前医生跟我说一般gbm病人术后愈后不会太好，也就12个月的survival
time，手术的风险也很大，有可能下不了台子。所幸的是手术非常成功，我爸爸手术后
恢复的也不错，也做了化疗和放疗巩固，基本功能都恢复了。除了放化疗，他过了大概
18月几乎象健康人一样的生活，还出去讲课，短期旅游什么的，可是gbm是手术也清不
干净的，18月后，tumor又卷土重来开始压迫神经，影响到他一侧的腿，手和吞咽，医
生说只是因为年龄（70岁），tumor长的相对慢一些。后来2年多，他就几乎完全卧床，
靠鼻饲进食，生活质量很差。我爸爸去年10月去世了，在确诊gbm后survive了4年半。
从他生病，我也看了很多资料，在国内的家人也到处求医问药，我爸爸在放疗后一直从
一个中医那里吃中药，根据他的状况对处方时时调整，也建议喝羚羊角粉冲的水说是帮
助减低颅压。这个病中国和美国基本没有什么特殊有效的治疗方法，西医就是手术，化
疗和放疗巩固。家人要做好准备，因为脑瘤通常都会压迫某些神经，病人的mobility，
吞咽，情绪，思维都会受到影响。我爸爸后来两年就不怎么认识我了，也没有办法进行
正常的交流。不管怎样，希望你朋友的父亲能够出现奇迹。

f*o2010-08-07 07:08

46 楼

GBM, glioblastoma, survive了4年半, this is already a miracle
average survivla is only a little bit more than one year
过了大概18月几乎象健康人一样的生活 this is miracle

H*a2010-08-07 07:08

47 楼

是的，虽然爸爸去世心里上还是很难接受，但这的确算是个miracle了。主要是1）手术
作的非常成功，大夫的技术还是很棒的；2）年龄大，后来tumor卷土重来的时候发展相
对慢，3）不知道是不是原因，但家里人相信看中医吃调理的药也帮助延缓了tumor的发
展。

【在 f****o 的大作中提到】

: GBM, glioblastoma, survive了4年半, this is already a miracle
: average survivla is only a little bit more than one year
: 过了大概18月几乎象健康人一样的生活 this is miracle