Mathieu David, Iorio-Morin Christian
Division of Neurosurgery, Department of Surgery, Université de Sherbrooke, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada,
Division of Neurosurgery, Department of Surgery, Université de Sherbrooke, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada.
Prog Neurol Surg. 2019;34:173-183. doi: 10.1159/000493062. Epub 2019 May 16.
Pineal region tumors represent a heterogeneous group of different histologic entities, for which the management can be a significant challenge, due to their critical location and frequent aggressive behavior. Traditional management includes surgical resection, fractionated radiation therapy, and chemotherapy. Stereotactic radiosurgery (SRS) is being increasingly used in the treatment of these tumors. It is used as primary therapy for pineocytomas and papillary tumors of the pineal region, as an adjuvant radiation boost in combination with radiation or chemotherapy for pineoblastomas and germ cell tumors, or in the context of tumor recurrence. The reported morbidity is low, consisting in transient oculomotor disturbance in most cases. As a non-invasive alternative to microsurgical resection, SRS should always be considered when discussing these challenging cases.
松果体区肿瘤是一组组织学类型各异的异质性肿瘤，由于其位置关键且行为常具侵袭性，其治疗颇具挑战。传统治疗方法包括手术切除、分次放射治疗和化疗。立体定向放射外科（SRS）在这些肿瘤的治疗中应用越来越广泛。它被用作松果体细胞瘤和松果体区乳头状肿瘤的主要治疗方法，作为松果体母细胞瘤和生殖细胞肿瘤放疗或化疗联合的辅助放疗增强手段，或用于肿瘤复发的情况。报道的发病率较低，大多数情况下表现为短暂的动眼神经功能障碍。作为显微手术切除的非侵入性替代方法，在讨论这些具有挑战性的病例时应始终考虑SRS。
