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首页> 外文期刊>Medical and Pediatric Oncology: The Official Journal of the American Association for Cancer Education >Germ cell tumours of the central nervous system in children-controversies in radiotherapy.
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Germ cell tumours of the central nervous system in children-controversies in radiotherapy.

机译：儿童放射治疗中枢神经系统生殖细胞肿瘤的争议。

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BACKGROUND: Primary germ cell tumours (GCT) of the central nervous system (CNS) are rare tumours of children and adults. As few prospective, randomised trials have been published, management decisions are often based on retrospective and historical studies, histology, age, performance status, and extent of disease at diagnosis. This article reviews the current controversies in the radiotherapeutic management of primary GCT of the CNS. PROCEDURE: A computerised literature search was performed using the Medline database from 1975 to 2000, this being limited to publications written in the English language on CNS GCT in children up to the age of 16 years. RESULTS: Issues in radiation therapy currently undergoing review include the role of cranio-spinal irradiation (CSI), radiation therapy field sizes, the radiation therapy dose, the extent of surgery in combination with radiotherapy, and the role and timing of chemotherapy in combination with radiotherapy. CONCLUSIONS: The excellent outcome in children with pure germinoma of the CNS and the long-term morbidity associated with standard therapy justifies attempts to limit both the total radiation dose and field sizes, with or without the addition of chemotherapy. The poorer outcome associated with non-germinoma GCT justifies a more aggressive approach in children, combining chemotherapy, surgery and virgule, or radiation therapy, based on known prognostic factors. Copyright 2003 Wiley-Liss, Inc.
机译：背景：中枢神经系统（CNS）的原发性生殖细胞肿瘤（GCT）是儿童和成人的罕见肿瘤。由于几乎没有前瞻性，随机试验发表，因此管理决策通常基于回顾性和历史研究，组织学，年龄，表现状态以及诊断时的疾病程度。本文回顾了中枢神经系统原发性GCT放射治疗管理中的当前争议。程序：从1975年到2000年，使用Medline数据库进行了计算机文献检索，仅限于16岁以下儿童在CNS GCT上用英语撰写的出版物。结果：目前正在审查的放射治疗问题包括颅脊髓照射（CSI）的作用，放射治疗领域的大小，放射治疗的剂量，与放射治疗相结合的手术范围，以及与放射化学相结合的化学治疗的作用和时机放疗。结论：纯净的中枢神经系统生殖细胞瘤患儿的出色疗效以及与标准疗法相关的长期发病率证明了在限制或不限制化疗的情况下限制总辐射剂量和视野大小的尝试是合理的。与非生殖细胞瘤GCT相关的较差结果证明，根据已知的预后因素，将化疗，手术和小剂量或放射疗法相结合的儿童应采用更具侵略性的方法。版权所有2003 Wiley-Liss，Inc.

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