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Multi-modality management of craniopharyngioma: a review of various treatments and their outcomes

机译:颅咽管瘤的多模式管理:各种治疗方法及其结果的审查

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摘要

Craniopharyngioma is a rare tumor that is expected to occur in ∼400 patients/year in the United States. While surgical resection is considered to be the primary treatment when a patient presents with a craniopharyngioma, only 30% of such tumors present in locations that permit complete resection. Radiotherapy has been used as both primary and adjuvant therapy in the treatment of craniopharyngiomas for over 50 years. Modern radiotherapeutic techniques, via the use of CT-based treatment planning and MRI fusion, have permitted tighter treatment volumes that allow for better tumor control while limiting complications. Modern radiotherapeutic series have shown high control rates with lower doses than traditionally used in the two-dimensional treatment era. Intracavitary radiotherapy with radio-isotopes and stereotactic radiosurgery may have a role in the treatment of recurrent cystic and solid recurrences, respectively. Recently, due to the exclusive expression of the Beta-catenin clonal mutations and the exclusive expression of BRAF V600E clonal mutations in the overwhelming majority of adamantinomatous and papillary tumors respectively, it is felt that inhibitors of each pathway may play a role in the future treatment of these rare tumors.
机译:颅咽管瘤是一种罕见的肿瘤,在美国预计每年约有400例患者发生。当患者出现颅咽管瘤时,手术切除被认为是主要治疗方法,但只有30%的此类肿瘤存在于可以完全切除的位置。放射疗法在治疗颅咽管瘤方面已被用作主要疗法和辅助疗法,已有50多年的历史了。通过使用基于CT的治疗计划和MRI融合技术,现代放射治疗技术允许更严格的治疗量,从而可以更好地控制肿瘤并限制并发症的发生。与二维治疗时代传统使用的放射治疗相比,现代放射治疗系列已显示出更高的控制率和更低的剂量。放射性同位素腔内放疗和立体定向放射手术可能分别在复发性囊性和实体性复发的治疗中起作用。最近,由于β-catenin克隆突变的独家表达和BRAF V600E克隆突变的独家表达分别在绝大多数的金刚棉瘤和乳头状肿瘤中表达,因此认为每种途径的抑制剂可能在未来的治疗中发挥作用这些罕见的肿瘤。

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