Departments of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Departments of Neurosurgery, The University of Texas MD Anderson Cancer Center, 1400 Holcombe Blvd, Rm FC7.2000, Unit 442, Houston, TX, 77030, USA.
J Neurooncol. 2020 Dec;150(3):393-403. doi: 10.1007/s11060-020-03497-6. Epub 2020 Apr 18.
Skull base primary malignancies represent a heterogeneous group of histologic diagnoses and sarcomas of the skull base are specific malignant tumors that arise from mesenchymal cells and can be classified by site of origin into bony and soft tissue sarcomas. The most common bony sarcomas include: chondrosarcoma, osteosarcoma, chordoma, Ewing's sarcoma. Given the relative rarity of each histologic diagnosis, especially in the skull base, there is limited published data to guide the management of patients with skull base sarcomas. An electronic search of the literature was performed to obtain key publications in the management of bony sarcomas of the skull base published within the last decade. This article is thus a review of the multi-disciplinary management principles of primary bony sarcomas of the skull base. Of note, there have been several recent advancements in the realm of skull base sarcoma management that have resulted in improved survival. These include advances in: imaging and diagnostic techniques, surgical techniques that incorporate oncologic surgical principles, conformal radiation paradigms and targeted systemic therapies. Early access to coordinated multi-disciplinary subspecialty care immediately at suspicion of diagnosis has further improved outcomes. There are several ongoing trials in the realms of radiation therapy and systemic therapy that will hopefully provide further insight about the optimal management of bony sarcomas of the skull base.
颅底原发性恶性肿瘤是一组具有异质性组织学诊断的肿瘤，而颅底肉瘤是源自间充质细胞的特定恶性肿瘤，可根据起源部位分为骨和软组织肉瘤。最常见的骨源性肉瘤包括：软骨肉瘤、骨肉瘤、脊索瘤、尤文肉瘤。鉴于每种组织学诊断，尤其是在颅底，都相对罕见，因此，针对颅底肉瘤患者的管理，可用于指导的相关文献数据有限。对文献进行了电子检索，以获取过去十年中发表的关于颅底骨源性肉瘤管理的关键出版物。因此，本文综述了颅底原发性骨源性肉瘤的多学科管理原则。值得注意的是，颅底肉瘤管理领域最近有了一些进展，这些进展提高了生存率。其中包括影像学和诊断技术、结合肿瘤外科原则的外科技术、适形放射治疗模式和靶向系统治疗的进步。在诊断怀疑时尽早获得协调的多学科专业医疗服务，进一步改善了治疗效果。目前有几个关于放射治疗和系统治疗的临床试验正在进行中，有望进一步深入了解颅底骨源性肉瘤的最佳管理方法。
