...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Neurosurgical focus >Management and outcome of recurrent adult craniopharyngiomas: an analysis of 42 cases with long-term follow-up
【24h】

Management and outcome of recurrent adult craniopharyngiomas: an analysis of 42 cases with long-term follow-up

机译：成人复发性颅咽管瘤的治疗和转归：长期随访42例分析

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

OBJECTIVE The treatment of recurrent and residual craniopharyngiomas is challenging. In this study the authors describe their experience with these tumors and make recommendations on their management. METHODS The authors performed an observational study of adult patients (≥ 18 years) with recurrent or residual craniopharyngiomas that were managed at their tertiary center. Retrospective data were collected on demographics and clinical, imaging, and treatment characteristics from patients who had a minimum 2-year follow-up. Descriptive statistics were used and the data were analyzed. RESULTS There were 42 patients (27 male, 15 female) with a mean age of 46.3 ± 14.3 years. The average tumor size was 3.1 ± 1.1 cm. The average time to first recurrence was 3.6 ± 5.5 years (range 0.2–27 years). One in 5 patients (8/42) with residual/recurrent tumors did not require any active treatment. Of the 34 patients who underwent repeat treatment, 12 (35.3%) had surgery only (transcranial, endoscopic, or both), 9 (26.5%) underwent surgery followed by adjuvant radiation therapy (RT), and 13 (38.2%) received RT alone. Eighty-six percent (18/21) had a gross-total (n = 4) or near-total (n = 14) resection of the recurrent/residual tumors and had good local control at last follow-up. One of 5 patients (7/34) who underwent repeat treatment had further treatment for a second recurrence. The total duration of follow-up was 8.6 ± 7.1 years. The average Karnofsky Performance Scale score at last follow-up was 80 (range 40–90). There was 1 death. CONCLUSIONS Based on this experience and in the absence of guidelines, the authors recommend an individualized approach for the treatment of symptomatic or growing tumors. This study has shown that 1 in 5 patients does not require repeat treatment of their recurrent/residual disease and can be managed with a “scan and watch” approach. On the other hand, 1 in 5 patients who had repeat treatment for their recurrence in the form of surgery and/or radiation will require further additional treatment. More studies are needed to best characterize these patients and predict the natural history of this disease and response to treatment.
机译：目的治疗复发性和残留性颅咽管瘤具有挑战性。在这项研究中，作者描述了他们对这些肿瘤的经验，并就其治疗提出了建议。方法作者进行了一项对成年患者（≥18岁）的复发或残留颅咽管瘤的观察研究，这些患者在其三级中心接受治疗。回顾性数据来自至少两年随访的患者的人口统计学和临床​​，影像学和治疗特征。使用描述性统计数据并分析数据。结果共有42例患者（男27例，女15例），平均年龄为46.3±14.3岁。平均肿瘤尺寸为3.1±1.1cm。首次复发的平均时间为3.6±5.5年（范围0.2–27年）。五分之一（8/42）残留/复发肿瘤的患者不需要任何积极治疗。在34例接受重复治疗的患者中，只有12例（35.3％）仅接受了手术（经颅，内镜或两者兼有），其中9例（26.5％）接受了辅助放射疗法（RT）的手术，其中13例（38.2％）接受了RT单独。 86％（18/21）切除了复发/残留肿瘤的总（n = 4）或几乎全部（n = 14），并且在最后一次随访中具有良好的局部控制。接受重复治疗的5例患者中有7例（7/34）再次复发。随访总时间为8.6±7.1年。最近一次随访的卡诺夫斯基绩效量表平均得分为80（范围40-90）。有1人死亡。结论基于这种经验，在没有指导原则的情况下，作者建议采用个体化方法来治疗有症状或正在生长的肿瘤。这项研究表明，五分之一的患者不需要对其复发/残留疾病进行重复治疗，并且可以通过“扫描和观察”方法进行治疗。另一方面，每5例因手术和/或放射形式复发而重复治疗的患者将需要进一步的治疗。需要更多的研究来最好地表征这些患者并预测该疾病的自然病史和对治疗的反应。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号