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青少年和青年的中枢神经系统肿瘤:神经肿瘤学会关于诊断、管理及未来方向的共识性综述

Central nervous system tumors in adolescents and young adults: A Society for Neuro-Oncology Consensus Review on diagnosis, management, and future directions.

作者信息

Lim-Fat Mary Jane, Bennett Julie, Ostrom Quinn, Touat Mehdi, Franceschi Enrico, Schulte Jessica, Bindra Ranjit S, Fangusaro Jason, Dhall Girish, Nicholson James, Jackson Sadhana, Davidson Tom Belle, Calaminus Gabriele, Robinson Giles, Whittle James R, Hau Peter, Ramaswamy Vijay, Pajtler Kristian W, Rudà Roberta, Foreman Nicholas K, Hervey-Jumper Shawn L, Das Sunit, Dirks Peter, Bi Wenya Linda, Huang Annie, Merchant Thomas E, Fouladi Maryam, Aldape Kenneth, Van den Bent Martin J, Packer Roger J, Miller Julie J, Reardon David A, Chang Susan M, Haas-Kogan Daphne, Tabori Uri, Hawkins Cynthia, Monje Michelle, Wen Patrick Y, Bouffet Eric, Yeo Kee Kiat

机构信息

Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada.

Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.

出版信息

Neuro Oncol. 2025 Jan 12;27(1):13-32. doi: 10.1093/neuonc/noae186.

Abstract

Adolescents and young adults (AYAs; ages 15-39 years) are a vulnerable population facing challenges in oncological care, including access to specialized care, transition of care, unique tumor biology, and poor representation in clinical trials. Brain tumors are the second most common tumor type in AYA, with malignant brain tumors being the most common cause of cancer-related death. The 2021 WHO Classification for central nervous system (CNS) Tumors highlights the importance of integrated molecular characterization with histologic diagnosis in several tumors relevant to the AYA population. In this position paper from the Society for Neuro-Oncology (SNO), the diagnosis and management of CNS tumors in AYA is reviewed, focusing on the most common tumor types in this population, namely glioma, medulloblastoma, ependymoma, and CNS germ cell tumor. Current challenges and future directions specific to AYA are also highlighted. Finally, possible solutions to address barriers in the care of AYA patients are discussed, emphasizing the need for multidisciplinary and collaborative approaches that span the pediatric and adult paradigms of care, and incorporating advanced molecular testing, targeted therapy, and AYA-centered care.

摘要

青少年和青年(AYA,年龄在15至39岁之间)是肿瘤护理方面面临挑战的弱势群体,这些挑战包括获得专科护理、护理过渡、独特的肿瘤生物学特性以及在临床试验中的代表性不足。脑肿瘤是AYA中第二常见的肿瘤类型,恶性脑肿瘤是癌症相关死亡的最常见原因。2021年世界卫生组织中枢神经系统(CNS)肿瘤分类强调了在与AYA人群相关的几种肿瘤中,将分子特征与组织学诊断相结合的重要性。在神经肿瘤学会(SNO)的这份立场文件中,对AYA中枢神经系统肿瘤的诊断和管理进行了综述,重点关注该人群中最常见的肿瘤类型,即胶质瘤、髓母细胞瘤、室管膜瘤和中枢神经系统生殖细胞肿瘤。还强调了AYA特有的当前挑战和未来方向。最后,讨论了应对AYA患者护理障碍的可能解决方案,强调需要跨越儿科和成人护理模式的多学科协作方法,并纳入先进的分子检测、靶向治疗和以AYA为中心的护理。

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