Shapiro K, Till K, Grant D N
J Neurosurg. 1979 May;50(5):617-23. doi: 10.3171/jns.1979.50.5.0617.
The authors review 60 children who presented with craniopharyngiomas. Patients were treated by either 1) cyst aspiration followed by deep x-ray therapy (DXT), 2) radical excision, 3) incomplete tumor excision, or 4) incomplete excision followed by DTX. Symptomatic clinical recurrence signified failure of treatment. Of the patients treated by cyst aspiration and DXT, 50% experienced recurrence (mean time after treatment, 4.4 years), while recurrences occurred in 23% undergoing radical excision (mean time, 2.4 years). Symptomatic recurrences occurred in 78% treated by incomplete removal only (mean time, 2.2 years). No recurrences have occurred in seven patients whose incomplete removal was followed by DTX. The authors conclude that radical excision is most likely to produce survival free of recurrence. When radical excision is not possible, DXT appears to provide an additional effect on preventing tumor regrowth. Characteristics of craniopharyngiomas favoring radical excision are also discussed.
作者回顾了60例颅咽管瘤患儿。患者接受了以下治疗之一：1）囊肿抽吸后深部X线治疗（DXT）；2）根治性切除；3）肿瘤不完全切除；4）不完全切除后行DTX。有症状的临床复发表示治疗失败。在接受囊肿抽吸和DXT治疗的患者中，50%出现复发（治疗后平均时间为4.4年），而行根治性切除的患者中23%出现复发（平均时间为2.4年）。仅接受不完全切除治疗的患者中有78%出现有症状的复发（平均时间为2.2年）。在7例不完全切除后接受DTX治疗的患者中未出现复发。作者得出结论，根治性切除最有可能实现无复发存活。当无法进行根治性切除时，DXT似乎对预防肿瘤复发有额外作用。文中还讨论了有利于根治性切除的颅咽管瘤特征。
