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儿童颅咽管瘤多模式管理的最新进展。

An update on multimodal management of craniopharyngioma in children.

作者信息

Lohkamp Laura-Nanna, Kasper Ekkehard Matthias, Pousa Alexandra Espinosa, Bartels Ute Katharina

机构信息

Division of Neurosurgery, Department of Surgery, The Hospital for Sick Children, Toronto, ON, Canada.

Division of Neurosurgery, St. Elizabeth's Medical Center, Boston University Medical School, Brighton, MA, United States.

出版信息

Front Oncol. 2023 May 5;13:1149428. doi: 10.3389/fonc.2023.1149428. eCollection 2023.

Abstract

Craniopharyngioma (CP) represent 1.2-4.6% of all intracranial tumors in children and carry a significant morbidity due to their lesional intimacy with structures involved in neurological, visual, and endocrinological functions. Variable treatment modalities being available, including surgery, radiation therapy, alternative surgeries, and intracystic therapies or combinations of them, their common goal is to reduce immediate and long-term morbidity while preserving these functions. Multiple attempts have been made to re-evaluate surgical and irradiation strategies in order to optimize their complication and morbidity profile. However, despite significant advances in "function sparing" approaches, such as limited surgery and improved technologies of radiation therapies, achieving interdisciplinary consensus on the optimal treatment algorithm remains a challenge. Furthermore, there remains a significant span of improvement given the number of specialties involved as well as the complex and chronic nature of CP disease. This perspective article aims to summarize recent changes and knowledge gains in the field of pediatric CP, outlining updated treatment recommendations, a concept of integrative interdisciplinary care and the implication of novel potential diagnostic tools. A comprehensive update on the multimodal treatment of pediatric CP is presented, focusing on "function-preserving" therapies and their implications.

摘要

颅咽管瘤(CP)占儿童所有颅内肿瘤的1.2% - 4.6%,由于其病变与神经、视觉和内分泌功能相关结构密切相邻,会导致显著的发病率。现有多种治疗方式,包括手术、放射治疗、替代手术、囊内治疗或它们的联合应用,其共同目标是在保留这些功能的同时降低近期和远期发病率。人们多次尝试重新评估手术和放疗策略,以优化其并发症和发病率情况。然而,尽管在“功能保留”方法上取得了显著进展,如有限手术和改进的放射治疗技术,但就最佳治疗方案达成跨学科共识仍然是一项挑战。此外,鉴于涉及的专业数量以及CP疾病的复杂和慢性性质,仍有很大的改进空间。这篇观点文章旨在总结小儿CP领域的最新变化和知识收获,概述更新的治疗建议、综合跨学科护理的概念以及新型潜在诊断工具的意义。本文全面介绍了小儿CP的多模式治疗进展,重点关注“功能保留”疗法及其影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98bf/10196165/d96de1ac2ea9/fonc-13-1149428-g001.jpg

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