Cáceres Adrián
Neurosurgery, National Children's Hospital, San José, Costa Rica.
Childs Nerv Syst. 2005 Aug;21(8-9):705-18. doi: 10.1007/s00381-005-1227-0. Epub 2005 Jul 19.
Craniopharyngioma remains an entity of controversial management due to its critical anatomical relationships and its well-known recurrence tendency. Total resection, although desirable, is not always accomplished, and it is associated with potentially permanent endocrinological and visual deficits. Consequently, this situation has led to the development of new management strategies seeking lesser morbidity. Because a high percentage of these lesions are cystic, bleomycin and radioactive-emitting sources have been postulated as new therapeutic options with promising results.
The information known to date regarding these substances is summarized and we perform a retrospective review of the clinical trials conducted over the past 30 years with special emphasis on outcome, morbidity, and mortality. Two cases from our institution are presented as examples of multimodality management.
Overall, these newer options stand out as valid alternatives in the controversial management of these challenging tumors.
颅咽管瘤因其关键的解剖关系和众所周知的复发倾向，仍然是一个治疗存在争议的疾病。全切除虽然是理想的，但并不总是能够实现，而且全切除会伴有潜在的永久性内分泌和视觉功能缺损。因此，这种情况促使了新的治疗策略的发展，以寻求更低的发病率。由于这些病变中有很大比例是囊性的，博来霉素和放射源已被认为是有前景的新治疗选择。
总结了迄今为止已知的关于这些物质的信息，并对过去30年进行的临床试验进行了回顾性分析，特别强调了结果、发病率和死亡率。作为多模式治疗的例子，展示了我们机构的两个病例。
总体而言，在这些具有挑战性的肿瘤的争议性治疗中，这些新的治疗选择是有效的替代方案。
