Serova N K, Grigorieva N N, Khavboshina A G, Butenko E I, Kobyakov G L, Poddubskiy A A, Trunin Yu Yu
Burdenko Neurosurgery Center, Moscow, Russia.
Zh Vopr Neirokhir Im N N Burdenko. 2021;85(1):78-86. doi: 10.17116/neiro20218501178.
The analyze the neuro-ophthalmic outcomes in patients with pineal and suprasellar germinoma after complex treatment.
There were 125 patients (88 males, 37 females) with primary CNS germinoma for the period 2008-2017. All patients were divided into 3 groups depending on the tumor localization: pineal area - 62 patients, suprasellar neoplasm - 38 patients, bifocal germinoma - 25 patients. Treatment was performed in accordance with the «Germinoma-2008» protocol. Tumors were histologically patients (partial - 32 cases, subtotal - 16 cases). Surgery was followed by postoperative chemotherapy and stereotactic radiotherapy. The results were evaluated by neuro-ophthalmological examination at all stages of complex treatment.
Pineal germinoma resulted oculomotor and pupillary disorders (58 patients - 94%) and papilledema. The last one completely regressed under the treatment. Partial reduction of oculomotor and pupillary abnormalities occurred throughout chemotherapy (6 patients - 10%). More than half of patients (=24, 63%) with suprasellar germinoma had visual impairment. Improvement of visual functions including severe visual disturbance was observed in 14 patients (58%). Predominantly, functional recovery occurred under chemotherapy (12 patients - 86%). Bifocal germinoma was followed by various combinations of oculomotor, pupillary and/or visual impairments. We observed regression of only mild visual disorders. Stereotactic radiotherapy did not ensure any changes in neuro-ophthalmic symptoms in all groups.
分析松果体区和鞍上生殖细胞瘤患者在综合治疗后的神经眼科预后。
2008年至2017年期间，共有125例原发性中枢神经系统生殖细胞瘤患者（男性88例，女性37例）。根据肿瘤定位，所有患者分为3组：松果体区62例，鞍上肿瘤38例，双灶性生殖细胞瘤25例。治疗按照“生殖细胞瘤-2008”方案进行。肿瘤组织学类型为部分切除32例，次全切除16例。手术后进行辅助化疗和立体定向放疗。在综合治疗的各个阶段通过神经眼科检查评估结果。
松果体生殖细胞瘤导致动眼神经和瞳孔障碍（58例患者，占94%）以及视乳头水肿。后者在治疗过程中完全消退。在整个化疗过程中，动眼神经和瞳孔异常部分减轻（6例患者，占10%）。超过一半（=24，63%）的鞍上生殖细胞瘤患者有视力障碍。14例患者（58%）的视觉功能包括严重视力障碍有所改善。主要是在化疗期间功能恢复（12例患者，占86%）。双灶性生殖细胞瘤伴有动眼神经、瞳孔和/或视觉障碍的各种组合。我们仅观察到轻度视力障碍有所消退。立体定向放疗未能确保所有组的神经眼科症状有任何改变。
