Major Nicholas, Patel Neal A, Bennett Josiah, Novakovic Ena, Poloni Dana, Abraham Mickey, Brown Nolan J, Gendreau Julian L, Sahyouni Ronald, Loya Joshua
School of Medicine, Mercer University School of Medicine, Savannah, GA 31404, USA.
Department of Surgery, Eisenhower Army Medical Center, Augusta, GA 30905, USA.
J Pers Med. 2022 Jun 27;12(7):1050. doi: 10.3390/jpm12071050.
Tumors of the central nervous system are the most common solid malignancies diagnosed in children. While common, they are also found to have some of the lowest survival rates of all malignancies. Treatment of childhood brain tumors often consists of operative gross total resection with adjuvant chemotherapy or radiotherapy. The current body of literature is largely inconclusive regarding the overall benefit of adjuvant chemo- or radiotherapy. However, it is known that both are associated with conditions that lower the quality of life in children who undergo those treatments. Chemotherapy is often associated with nausea, emesis, significant fatigue, immunosuppression, and alopecia. While radiotherapy can be effective for achieving local control, it is associated with late effects such as endocrine dysfunction, secondary malignancy, and neurocognitive decline. Advancements in radiotherapy grant both an increase in lifetime survival and an increased lifetime for survivors to contend with these late effects. In this review, the authors examined all the published literature, analyzing the results of clinical trials, case series, and technical notes on patients undergoing radiotherapy for the treatment of tumors of the central nervous system with a focus on neurocognitive decline and survival outcomes.
中枢神经系统肿瘤是儿童中最常见的实体恶性肿瘤。虽然很常见，但它们也是所有恶性肿瘤中生存率最低的一些肿瘤。儿童脑肿瘤的治疗通常包括手术全切并辅以化疗或放疗。目前的文献对于辅助化疗或放疗的总体益处基本上没有定论。然而，已知这两种治疗都与降低接受这些治疗的儿童生活质量的状况有关。化疗通常会导致恶心、呕吐、严重疲劳、免疫抑制和脱发。虽然放疗对于实现局部控制可能有效，但它会带来诸如内分泌功能障碍、继发性恶性肿瘤和神经认知衰退等晚期效应。放疗技术的进步既提高了生存期生存率，也增加了幸存者应对这些晚期效应的寿命。在这篇综述中，作者查阅了所有已发表的文献，分析了关于接受放疗治疗中枢神经系统肿瘤患者的临床试验结果、病例系列和技术笔记，重点关注神经认知衰退和生存结果。
