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小儿颅咽管瘤的靶向治疗:20年囊内注射α干扰素治疗经验的教训

Targeted Treatment of Pediatric Craniopharyngioma: Lesson Learnt After 20-Year Experience with Intracystic Interferon Alpha.

作者信息

Frassanito Paolo, Massimi Luca, Bianchi Federico, Tamburrini Gianpiero

机构信息

Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Catholic University Medical School, Rome, Italy.

出版信息

Adv Tech Stand Neurosurg. 2025;55:93-110. doi: 10.1007/978-3-031-90762-3_5.

Abstract

Intracystic IFNα proved to be a safe and effective option in the multimodal management of cystic craniopharyngioma (CRF).In our institutional experience, controversial cases have arisen concern and unanswered questions, that are becoming more common with the availability of new target therapies for other brain tumors.Reliable criteria to define the response to treatment should be defined. Additionally, the best timing of surgical resection after target therapy is not clear. Surgery is postponed in case of favorable response, but tumor relapse may present a different architecture eventually increasing surgical morbidity. Finally, in case of good response to the target therapy a close follow-up is required, since rebound may occur in exceptional cases.These data should represent the benchmark for future studies using either systemic administration of IFN or other intracystic drugs.

摘要

囊内注射干扰素α被证明是囊性颅咽管瘤(CRF)多模式治疗中的一种安全有效的选择。根据我们机构的经验,出现了一些有争议的病例,引发了关注和未解决的问题,随着其他脑肿瘤新靶向治疗方法的出现,这些问题变得越来越普遍。应该定义可靠的治疗反应标准。此外,靶向治疗后手术切除的最佳时机尚不清楚。如果反应良好则推迟手术,但肿瘤复发最终可能呈现不同的结构,从而增加手术并发症。最后,如果对靶向治疗反应良好,则需要密切随访,因为在特殊情况下可能会出现反弹。这些数据应成为未来使用干扰素全身给药或其他囊内药物研究的基准。

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