Division of Hematology, Oncology, Neuro-Oncology, Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
Department of Pediatric Neurosurgery, Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania.
Neuro Oncol. 2020 Nov 26;22(11):1696-1704. doi: 10.1093/neuonc/noaa119.
Craniopharyngiomas account for approximately 1.2-4% of all CNS tumors. They are typically treated with a combination of surgical resection and focal radiotherapy. Unfortunately, treatment can lead to permanent deleterious effects on behavior, learning, and endocrine function.
The Pediatric Brain Tumor Consortium performed a multicenter phase 2 study in children and young adults with unresectable or recurrent craniopharyngioma (PBTC-039). Between December 2013 and November 2017, nineteen patients (median age at enrollment, 13.1 y; range, 2-25 y) were enrolled in one of 2 strata: patients previously treated with surgery alone (stratum 1) or who received radiation (stratum 2).
Eighteen eligible patients (8 male, 10 female) were treated with weekly subcutaneous pegylated interferon alpha-2b for up to 18 courses (108 wk). Therapy was well tolerated with no grade 4 or 5 toxicities. 2 of the 7 eligible patients (28.6%) in stratum 1 had a partial response, but only one response was sustained for more than 3 months. None of the 11 stratum 2 patients had an objective radiographic response, although median progression-free survival was 19.5 months.
Pegylated interferon alpha-2b treatment, in lieu of or following radiotherapy, was well tolerated in children and young adults with recurrent craniopharyngiomas. Although objective responses were limited, progression-free survival results are encouraging, warranting further studies.
颅咽管瘤约占所有中枢神经系统肿瘤的 1.2-4%。它们通常采用手术切除和局部放射治疗相结合的方法进行治疗。不幸的是,治疗可能会导致行为、学习和内分泌功能的永久性损害。
儿科脑瘤联盟(Pediatric Brain Tumor Consortium)在无法切除或复发的颅咽管瘤患儿和年轻成人中进行了一项多中心 2 期研究(PBTC-039)。在 2013 年 12 月至 2017 年 11 月期间,19 名患者(中位入组年龄为 13.1 岁;范围,2-25 岁)被纳入 2 个亚组之一:仅接受过手术治疗的患者(亚组 1)或接受过放疗的患者(亚组 2)。
18 名符合条件的患者(8 名男性,10 名女性)接受了每周皮下注射聚乙二醇化干扰素-α-2b 治疗,最多 18 个疗程(108 周)。治疗耐受性良好,无 4 级或 5 级毒性反应。亚组 1 中 7 名符合条件的患者中有 2 名(28.6%)有部分缓解,但只有 1 名缓解持续时间超过 3 个月。11 名亚组 2 患者均无客观影像学反应,但中位无进展生存期为 19.5 个月。
聚乙二醇化干扰素-α-2b 治疗,无论是在放疗之前还是之后,在复发颅咽管瘤的儿童和年轻成人中耐受性良好。虽然客观反应有限,但无进展生存期结果令人鼓舞,值得进一步研究。