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残余或复发颅咽管瘤的疗效改善:伽玛刀联合磷-32 近距离放疗的疗效评估。

Enhanced outcomes in residual or recurrent craniopharyngioma: evaluating combined gamma knife and phosphorus-32 brachytherapy.

机构信息

PLA Medical School, Beijing, 100853, People's Republic of China.

Department of Neurosurgery, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, People's Republic of China.

出版信息

Clin Transl Oncol. 2024 Sep;26(9):2198-2204. doi: 10.1007/s12094-024-03435-2. Epub 2024 Mar 15.

Abstract

BACKGROUND

Managing residual and recurrent craniopharyngioma effectively is crucial for improving patient outcomes. This study evaluates the combined use of gamma knife and phosphorus-32 brachytherapy, offering insights into alternative, less invasive treatment strategies.

METHODS

We conducted a retrospective analysis of 97 patients treated from 2010 to 2016 for residual and recurrent craniopharyngioma using gamma knife and phosphorus-32 brachytherapy. We classified these patients into three groups: superficial solid (Group A), simple cystic (Group B), and mixed cystic-solid (Group C). We assessed the treatment's effectiveness by the tumor control rates and evaluated safety by monitoring vision, endocrine function improvements, and complication rates.

RESULTS

The treatment achieved complete and adequate control rates of 49.5% and 87.6%, respectively. We observed improvements in vision or visual fields in 55.1% of the patients. The morbidity rate was 15.5%. The study found no significant differences in tumor control rates among the various lesion types.

CONCLUSION

The combination of gamma knife and phosphorus-32 brachytherapy presents a viable, minimally invasive alternative for treating residual and recurrent craniopharyngioma. It offers high tumor control and functional improvement rates, suggesting its potential as a preferred strategy in some instances.

摘要

背景

有效地管理颅咽管瘤的残余和复发对于改善患者的预后至关重要。本研究评估了伽玛刀和磷-32 近距离放疗的联合应用,为替代、微创的治疗策略提供了新的思路。

方法

我们对 2010 年至 2016 年间接受伽玛刀和磷-32 近距离放疗治疗的 97 例残余和复发性颅咽管瘤患者进行了回顾性分析。我们将这些患者分为三组:表浅实性(A 组)、单纯囊性(B 组)和混合囊性-实性(C 组)。我们通过肿瘤控制率评估治疗的有效性,并通过监测视力、内分泌功能改善和并发症发生率评估安全性。

结果

治疗的完全和充分控制率分别为 49.5%和 87.6%。我们观察到 55.1%的患者视力或视野得到改善。发病率为 15.5%。研究发现,不同病变类型之间的肿瘤控制率没有显著差异。

结论

伽玛刀和磷-32 近距离放疗联合治疗是治疗颅咽管瘤残余和复发的一种可行的、微创的替代方法。它具有较高的肿瘤控制率和功能改善率,提示在某些情况下可能是一种首选策略。

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