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射波刀放射外科治疗复发性脉络丛癌:病例说明

Recurrent choroid plexus carcinoma treated with CyberKnife radiosurgery: illustrative case.

作者信息

Yuan Lorenzo, Park David J, Persad Amit R L, Hori Yusuke S, Tayag Armine, Ustrzynski Louisa, Emrich Sara C, Chang Steven D

机构信息

Department of Neurosurgery, Stanford University School of Medicine, Stanford, California.

出版信息

J Neurosurg Case Lessons. 2024 Jul 8;8(2). doi: 10.3171/CASE23748.

Abstract

BACKGROUND

Choroid plexus carcinomas (CPCs) are rare malignant brain tumors primarily affecting children younger than 2 years old. These tumors originate from the choroid plexus epithelium and are a subtype of choroid plexus tumors, which account for 1%-4% of pediatric brain tumors. Although CPCs often show a notably high recurrence rate after surgery, the standard treatment approach remains gross-total resection (GTR) of the tumor, given the lack of clinical data supporting the effectiveness of adjunct treatment options such as radiotherapy or chemotherapy.

OBSERVATIONS

A 16-year-old female with a history of a recurrent cranial CPC resistant to surgery and radiotherapy was treated with CyberKnife stereotactic radiosurgery (SRS), following resection. The procedures successfully maintained local disease control for 41 months; however, there was a subsequent recurrence, ultimately leading to the death of the patient.

LESSONS

CPC treatment remains challenging. SRS can be used as a viable adjunct to surgery, which remains the gold standard, although it can also be considered for nonsurgical candidates or when GTR cannot be achieved. Nevertheless, it is crucial to conduct additional research to explore diverse approaches for radiosurgery, including its role as the primary treatment modality versus its combination with surgery, radiotherapy, or chemotherapy. https://thejns.org/doi/10.3171/CASE23748.

摘要

背景

脉络丛癌(CPCs)是一种罕见的恶性脑肿瘤,主要影响2岁以下儿童。这些肿瘤起源于脉络丛上皮,是脉络丛肿瘤的一种亚型,占小儿脑肿瘤的1%-4%。尽管CPCs术后常显示出较高的复发率,但鉴于缺乏支持放疗或化疗等辅助治疗方案有效性的临床数据,标准治疗方法仍是肿瘤的全切除(GTR)。

观察结果

一名16岁女性,有复发性颅CPC病史,对手术和放疗均耐药,在切除术后接受了射波刀立体定向放射外科治疗(SRS)。该治疗成功维持局部疾病控制41个月;然而,随后出现复发,最终导致患者死亡。

经验教训

CPC的治疗仍然具有挑战性。SRS可作为手术的可行辅助手段,手术仍是金标准,尽管对于非手术候选者或无法实现GTR的情况也可考虑使用SRS。然而,开展更多研究以探索放射外科的多种方法至关重要,包括其作为主要治疗方式的作用以及与手术、放疗或化疗联合使用的情况。https://thejns.org/doi/10.3171/CASE23748。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/315f/11284659/90fcca086d04/CASE23748_figure_1.jpg

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