EANO 指南：前庭神经鞘瘤的诊断与治疗。
EANO guideline on the diagnosis and treatment of vestibular schwannoma.
机构信息
Center of Neurosurgery, Department of General Neurosurgery, University of Cologne, Cologne, Germany.
Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland.
出版信息
Neuro Oncol. 2020 Jan 11;22(1):31-45. doi: 10.1093/neuonc/noz153.
Abstract
The level of evidence to provide treatment recommendations for vestibular schwannoma is low compared with other intracranial neoplasms. Therefore, the vestibular schwannoma task force of the European Association of Neuro-Oncology assessed the data available in the literature and composed a set of recommendations for health care professionals. The radiological diagnosis of vestibular schwannoma is made by magnetic resonance imaging. Histological verification of the diagnosis is not always required. Current treatment options include observation, surgical resection, fractionated radiotherapy, and radiosurgery. The choice of treatment depends on clinical presentation, tumor size, and expertise of the treating center. In small tumors, observation has to be weighed against radiosurgery, in large tumors surgical decompression is mandatory, potentially followed by fractionated radiotherapy or radiosurgery. Except for bevacizumab in neurofibromatosis type 2, there is no role for pharmacotherapy.
摘要
与其他颅内肿瘤相比，提供前庭神经鞘瘤治疗建议的证据水平较低。因此，欧洲神经肿瘤学协会的前庭神经鞘瘤工作组评估了文献中的可用数据，并为医疗保健专业人员制定了一套建议。前庭神经鞘瘤的放射学诊断通过磁共振成像进行。并不总是需要对诊断进行组织学验证。目前的治疗选择包括观察、手术切除、分次放疗和放射外科治疗。治疗选择取决于临床表现、肿瘤大小和治疗中心的专业知识。在小肿瘤中，需要权衡观察与放射外科治疗的利弊，在大肿瘤中，必须进行手术减压，可能随后进行分次放疗或放射外科治疗。除了神经纤维瘤病 2 型中的贝伐单抗外，药物治疗没有作用。
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Neurooncol Pract. 2016 Dec;3(4):281-289. doi: 10.1093/nop/npv065. Epub 2016 Jan 7.
2
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