Suárez Carlos, López Fernando, Mendenhall William M, Andreasen Simon, Mikkelsen Lauge Hjorth, Langendijk Johannes A, Bondi Stefano, Rodrigo Juan P, Bäck Leif, Mäkitie Antti A, Fernández-Alvarez Verónica, Coca-Pelaz Andrés, Smee Robert, Rinaldo Alessandra, Ferlito Alfio
Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, ISCIII, Oviedo, Spain.
Instituto Universitario de Oncología del Principado de Asturias, Universidad of Oviedo, Oviedo, Spain.
Cancer Manag Res. 2021 Jan 18;13:463-478. doi: 10.2147/CMAR.S287410. eCollection 2021.
The aim of this review is to analyze the latest trends in the management of non-vestibular skull base and intracranial schwannomas in order to optimize tumor control and quality of life. Non-vestibular cranial nerve schwannomas are rare lesions, representing 5-10% of cranial nerve schwannomas. Management decisions should be individualized depending on tumor size, location and associated functional deficits. Generally, large sized schwannomas exerting significant mass effect with increased intracranial pressure are treated surgically. In some cases, even after optimal skull base resection, it is not possible to achieve a gross total resection because tumor location and extent and/or to reduce morbidity. Thus, subtotal resection followed by stereotactic radiosurgery or fractioned radiotherapy offers an alternative approach. In certain cases, stereotactic radiosurgery or radiotherapy alone achieves good tumor control rates and less morbidity to gross total resection. Finally, given the slow growth rate of most of these tumors, observation with periodic radiographic follow-up approach is also a reasonable alternative for small tumors with few, if any, symptoms.
本综述的目的是分析非前庭颅底和颅内神经鞘瘤治疗的最新趋势，以优化肿瘤控制和生活质量。非前庭颅神经鞘瘤是罕见病变，占颅神经鞘瘤的5%-10%。治疗决策应根据肿瘤大小、位置及相关功能缺损进行个体化制定。一般来说，体积较大、产生明显占位效应且颅内压升高的神经鞘瘤采用手术治疗。在某些情况下，即使进行了最佳的颅底切除，由于肿瘤位置和范围及/或为了降低发病率，也无法实现全切除。因此，次全切除后联合立体定向放射外科或分次放疗提供了另一种方法。在某些情况下，单纯立体定向放射外科或放疗可实现良好的肿瘤控制率，且发病率低于全切除。最后，鉴于大多数此类肿瘤生长缓慢，对于症状轻微或无症状的小肿瘤，采用定期影像学随访观察也是一种合理的选择。
