Fauchon F, Jouvet A, Paquis P, Saint-Pierre G, Mottolese C, Ben Hassel M, Chauveinc L, Sichez J P, Philippon J, Schlienger M, Bouffet E
Centre de Radiothérapie Privé, Nice, France.
Int J Radiat Oncol Biol Phys. 2000 Mar 1;46(4):959-68. doi: 10.1016/s0360-3016(99)00389-2.
The aim of this study was to identify factors that could lead to optimization of the management of pineal parenchymal tumors (PPT) which remains equivocal and controversial.
In order to determine factors that influence PPT prognosis, a series of 76 consecutive patients from 12 European centers with histologically proven tumors was retrospectively reviewed. The clinical records and material for histologic review were available in all cases. Follow-up was achieved in 90% of cases.
According to WHO classification, there were 19 pineocytomas, 28 intermediate and mixed PPT, and 29 pineoblastomas. According to a four-grade institutional classification, there were 11 Grade 1, 27 Grade 2, 20 Grade 3, and 18 Grade 4. Surgical resection was attempted in 44 patients, whereas 30 had biopsy only. In one case, diagnosis was made at autopsy and in another on spinal deposits. Forty-four patients were irradiated following surgery, 15 patients received chemotherapy. Forty-one patients were alive (median follow-up: 85 months); 9 patients died perioperatively; 26 patients relapsed. Univariate analysis showed a good outcome correlated with age above 20 years, tumor diameter less than 25 mm, and low-grade histology. Multivariate analysis confirmed histology and tumor volume to be significant independent prognostic factors. The extent of surgery and radiotherapy had no clear influence on survival.
This review highlights the prognostic features of PPT and may help to determine treatment strategies based on radiologic and pathologic characteristics.
本研究旨在确定可能有助于优化松果体实质肿瘤（PPT）管理的因素，目前其管理仍不明确且存在争议。
为确定影响PPT预后的因素，回顾性分析了来自12个欧洲中心的76例经组织学证实患有肿瘤的连续患者。所有病例均有临床记录和组织学检查材料。90%的病例获得了随访。
根据世界卫生组织分类，有19例松果体细胞瘤、28例中间型和混合型PPT以及29例松果体母细胞瘤。根据四级机构分类，有11例1级、27例2级、20例3级和18例4级。44例患者尝试进行手术切除，而30例仅进行了活检。1例在尸检时确诊，另1例在脊髓转移灶处确诊。44例患者术后接受了放疗，15例患者接受了化疗。41例患者存活（中位随访时间：85个月）；9例患者围手术期死亡；26例患者复发。单因素分析显示，良好的预后与20岁以上、肿瘤直径小于25 mm以及低级别组织学相关。多因素分析证实组织学和肿瘤体积是重要的独立预后因素。手术范围和放疗对生存无明显影响。
本综述强调了PPT的预后特征，可能有助于根据影像学和病理学特征确定治疗策略。
