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放疗后成人松果体母细胞瘤完全消退:一例报告并文献复习

Complete regression of adult pineoblastoma following radiotherapy: A case report and review of the literature.

作者信息

Ai Ping, Peng Xingchen, Jiang Yong, Zhang Hong, Wang Shichao, Wei Yuquan

机构信息

Department of Head and Neck Oncology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan 610041, P.R. China.

Department of Pathology, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan 610041, P.R. China.

出版信息

Oncol Lett. 2015 Oct;10(4):2329-2332. doi: 10.3892/ol.2015.3574. Epub 2015 Aug 4.

Abstract

Adult pineoblastomas (PBs) are rare central nervous system tumors. Little is known with regard to the clinical features and outcomes of adult PB, and optimal treatment strategies for adult PB remain to be determined. The current report describes a case of PB in a 46-year-old male, who presented with obstructive hydrocephalus due to a large pineal region mass. Considering the potential effect on quality of life, the patient underwent a partial resection. Postoperative radiotherapy, comprising prophylactic craniospinal irradiation at a dose of 34.2 Gy followed by a local 25.3-Gy 'boost' to the tumor site for a total dose of 59.5 Gy, resulted in the complete regression of the tumor without neurological deficits. The patient has remained free of recurrence for 36 months after radiotherapy. This case highlights a minimally invasive strategy to treat a rare pineal region tumor with significant involvement of critical structures that resulted in a favorable response and an excellent neurological outcome. The radiographic and histopathological features of PB are also reviewed, and the various treatment options reported in the literature are discussed.

摘要

成人松果体母细胞瘤(PBs)是罕见的中枢神经系统肿瘤。关于成人PB的临床特征和预后知之甚少,成人PB的最佳治疗策略仍有待确定。本报告描述了一例46岁男性的PB病例,该患者因松果体区巨大肿块出现梗阻性脑积水。考虑到对生活质量的潜在影响,患者接受了部分切除术。术后放疗包括34.2 Gy的预防性全脑脊髓照射,随后对肿瘤部位进行25.3 Gy的局部“增强”照射,总剂量为59.5 Gy,结果肿瘤完全消退且无神经功能缺损。放疗后患者已无复发36个月。该病例突出了一种微创策略,用于治疗罕见的松果体区肿瘤,该肿瘤严重累及关键结构,却取得了良好的反应和出色的神经学结果。文中还回顾了PB的影像学和组织病理学特征,并讨论了文献中报道的各种治疗选择。

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本文引用的文献

1
Radiation therapy in pediatric pineal tumors.
Neurochirurgie. 2015 Apr-Jun;61(2-3):212-5. doi: 10.1016/j.neuchi.2014.11.002. Epub 2015 Jan 19.
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Post-chemotherapy maturation of a pineoblastoma.松果体母细胞瘤化疗后的成熟
Acta Neuropathol. 2010 May;119(5):651-3. doi: 10.1007/s00401-010-0668-z. Epub 2010 Mar 12.
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8
Pinealoblastomas in children.儿童松果体母细胞瘤
Childs Nerv Syst. 2006 Jun;22(6):577-85. doi: 10.1007/s00381-006-0095-6. Epub 2006 Mar 23.

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