Department of Neurological Surgery, University of California, San Francisco, California 94117, USA.
J Neurosurg. 2010 Aug;113(2):319-24. doi: 10.3171/2009.12.JNS091683.
Pineocytoma is a rare tumor, and the current literature on these tumors is primarily composed of case reports and small case series. Thus, recommendations on appropriate treatment of these tumors are highly varied. Therefore, the authors performed a systematic review of the literature on tumor control after surgery for pineocytoma to determine the relative benefits of aggressive resection and postoperative adjuvant radiotherapy.
A comprehensive search of the published English-language literature was performed to identify studies citing outcome data of patients undergoing surgery for pineocytoma. Determination of rates of progression-free survival (PFS) was performed using Kaplan-Meier analysis.
Sixty-four articles met the criteria of the established search protocol, which combined for a total of 166 patients. Twenty-one percent of these patients had undergone a biopsy procedure, 38% had undergone subtotal resection (STR), 42% had undergone gross-total resection, and 28% were treated with radiation therapy. The 1- and 5-year PFS rates for the resection group versus the biopsy group were 97 and 90% (1 year), and 89 and 75% (5 years), respectively (p < 0.05, log-rank test). The 1- and 5-year PFS rates for the GTR group versus the group undergoing STR combined with radiation therapy were 100 and 94% (1 year), and 100 and 84% (5 years), respectively (p < 0.05, log-rank test). There was no significant difference in PFS for STR only compared with STR in addition to radiation therapy.
Gross-total resection is the ideal treatment for pineocytoma and might represent a cure for these lesions. When gross-total resection is not possible, adjuvant radiation therapy after STR is of questionable benefit for these patients.
成松果体细胞瘤是一种罕见的肿瘤，目前关于此类肿瘤的文献主要由病例报告和小病例系列组成。因此，关于这些肿瘤的适当治疗建议差异很大。因此，作者对松果体细胞瘤手术后肿瘤控制的文献进行了系统回顾，以确定积极切除和术后辅助放疗的相对益处。
对已发表的英文文献进行全面搜索，以确定报道松果体细胞瘤患者接受手术治疗后无进展生存（PFS）数据的研究。采用 Kaplan-Meier 分析确定无进展生存率（PFS）。
符合既定搜索方案标准的 64 篇文章共纳入 166 例患者。其中 21%的患者接受了活检，38%的患者接受了次全切除术（STR），42%的患者接受了大体全切除术，28%的患者接受了放射治疗。切除组与活检组的 1 年和 5 年 PFS 率分别为 97%和 90%（1 年）和 89%和 75%（5 年）（p<0.05，log-rank 检验）。GTR 组与 STR 联合放疗组的 1 年和 5 年 PFS 率分别为 100%和 94%（1 年）和 100%和 84%（5 年）（p<0.05，log-rank 检验）。STR 组与 STR 加放疗组的 PFS 率无显著差异。
大体全切除术是治疗松果体细胞瘤的理想方法，可能是这些病变的治愈方法。当无法进行大体全切除时，STR 后辅助放疗对这些患者的益处值得怀疑。
