Chargari Cyrus, Bauduceau Olivier, Bauduceau Bernard, Camparo Philippe, Ceccaldi Bernard, Fayolle Maryse, Le Moulec Sylvestre, Védrine Lionel
Oncologie-radiothérapie, HIA Val de Grâce, 74 boulevard de Port-Royal, 75230 Paris Cedex 05.
Bull Cancer. 2007 Nov;94(11):987-94.
Craniopharyngiomas are benign tumors of the parasellar region, characterised by high relapsing rate. Aggressive attempt at total removal does result in prolonged progression-free survival in most patients. But for tumors that clearly involve the hypothalamus, complications associated with radical surgery have prompted to adopt a combined strategy of conservative surgery and radiation therapy to residual tumor with an as high rate of cure. This strategy seems to offer the best long-term control rates with acceptable morbidity. But optimal management of craniopharyngiomas remains controversial. Although it is generally recommended that radiotherapy is given following sub-total excision of a craniopharyngioma, it remains unclear as to whether all patients with residual tumour should receive immediate or differed at relapse radiotherapy.
颅咽管瘤是鞍旁区域的良性肿瘤,其特点是复发率高。积极尝试全切在大多数患者中确实能延长无进展生存期。但对于明显累及下丘脑的肿瘤,根治性手术相关的并发症促使人们采取保守手术和对残留肿瘤进行放射治疗的联合策略,以期达到较高的治愈率。这种策略似乎能提供最佳的长期控制率,且发病率可接受。但颅咽管瘤的最佳治疗方案仍存在争议。虽然一般建议在颅咽管瘤次全切除后进行放疗,但对于所有有残留肿瘤的患者是否应立即放疗或在复发时延迟放疗仍不明确。