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儿童中枢神经系统肿瘤,2023 年第 2 版,NCCN 肿瘤学临床实践指南。

Pediatric Central Nervous System Cancers, Version 2.2023, NCCN Clinical Practice Guidelines in Oncology.

机构信息

1St. Jude Children's Research Hospital/The University of Tennessee Health Science Center.

2Mayo Clinic Cancer Center.

出版信息

J Natl Compr Canc Netw. 2022 Dec;20(12):1339-1362. doi: 10.6004/jnccn.2022.0062.

Abstract

Central nervous system (CNS) cancers account for approximately one quarter of all pediatric tumors and are the leading cause of cancer-related death in children. More than 4,000 brain and CNS tumors are diagnosed each year in children and teens, and the incidence rate has remained stagnant in recent years. The most common malignant pediatric CNS tumors are gliomas, embryonal tumors consisting of predominately medulloblastomas, and germ cell tumors. The inaugural version of the NCCN Guidelines for Pediatric Central Nervous System Cancers focuses on the diagnosis and management of patients with pediatric diffuse high-grade gliomas. The information contained in the NCCN Guidelines is designed to help clinicians navigate the complex management of pediatric patients with diffuse high-grade gliomas. The prognosis for these highly aggressive tumors is generally poor, with 5-year survival rates of <20% despite the use of combined modality therapies of surgery, radiation therapy and systemic therapy. Recent advances in molecular profiling has expanded the use of targeted therapies in patients whose tumors harbor certain alterations. However, enrollment in a clinical trial is the preferred treatment for eligible patients.

摘要

中枢神经系统(CNS)癌症约占所有儿科肿瘤的四分之一,是儿童癌症相关死亡的主要原因。每年有超过 4000 例儿童和青少年被诊断出患有脑和 CNS 肿瘤,近年来发病率一直停滞不前。最常见的恶性小儿 CNS 肿瘤是神经胶质瘤、以髓母细胞瘤为主的胚胎性肿瘤和生殖细胞瘤。NCCN 儿科中枢神经系统癌症指南的初始版本侧重于诊断和管理患有小儿弥漫性高级别神经胶质瘤的患者。NCCN 指南中包含的信息旨在帮助临床医生为患有弥漫性高级别神经胶质瘤的儿科患者进行复杂的管理。尽管采用了手术、放射治疗和系统治疗相结合的综合治疗方法,这些高度侵袭性肿瘤的预后通常较差,5 年生存率<20%。分子谱分析的最新进展扩大了靶向治疗在某些肿瘤具有特定改变的患者中的应用。然而,对于符合条件的患者,参加临床试验是首选治疗方法。

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