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成人原发性中枢神经系统肿瘤治疗相关并发症的诊断与处理。

Diagnosis and management of complications from the treatment of primary central nervous system tumors in adults.

机构信息

Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland.

Department of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland.

出版信息

Neuro Oncol. 2023 Jul 6;25(7):1200-1224. doi: 10.1093/neuonc/noad038.

Abstract

Central nervous system (CNS) tumor patients commonly undergo multimodality treatment in the course of their disease. Adverse effects and complications from these interventions have not been systematically studied, but pose significant challenges in clinical practice and impact function and quality of life, especially in the management of long-term brain tumor survivors. Here, the European Association of Neuro-Oncology (EANO) has developed recommendations to prevent, diagnose, and manage adverse effects and complications in the adult primary brain CNS tumor (except lymphomas) patient population with a specific focus on surgery, radiotherapy, and pharmacotherapy. Specifically, we also provide recommendations for dose adaptations, interruptions, and reexposure for pharmacotherapy that may serve as a reference for the management of standard of care in clinical trials. We also summarize which interventions are unnecessary, inactive or contraindicated. This consensus paper should serve as a reference for the conduct of standard therapy within and outside of clinical trials.

摘要

中枢神经系统 (CNS) 肿瘤患者在疾病过程中通常会接受多模式治疗。这些干预措施的不良反应和并发症尚未得到系统研究,但在临床实践中带来了重大挑战,并影响了功能和生活质量,特别是在长期脑肿瘤幸存者的管理方面。在这里,欧洲神经肿瘤学会 (EANO) 制定了建议,以预防、诊断和管理成人原发性脑中枢神经系统肿瘤(除淋巴瘤外)患者人群的不良反应和并发症,特别关注手术、放疗和药物治疗。具体而言,我们还为药物治疗的剂量调整、中断和再暴露提供了建议,这可能为临床试验中标准护理的管理提供参考。我们还总结了哪些干预措施是不必要的、无效的或禁忌的。本共识文件应为临床试验内外标准治疗的开展提供参考。

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