亚当蒂诺马托斯膜瘤:管理的演变
Luca Massimi1,2, Davide Palombi3, Alessandra Musarra3
1Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy. lucamax30@hotmail.com.
概括
亚当丁诺马图斯瘤 (AC) 治疗已经进化,从侵略性手术转向综合方法. 当前的管理可以改善患者的生活质量 (QoL),而不会影响瘤控制或生存率.
科学领域:
- 儿科神经外科 儿科神经外科
- 儿科瘤学 儿科瘤学
- 神经瘤学神经瘤学
背景情况:
- 在儿童神经外科手术中,Adamantinomatous Craniopharyngioma (AC) 存在重大挑战,因为它位于重要结构附近的关键位置.
- 治疗可能导致严重的内分泌,认知和神经疾病,影响患者的生活质量 (QoL).
研究的目的:
- 为了提供一个 adamantinomatous craniopharyngioma (AC) 管理的历史概述.
- 突出AC治疗策略演变中的关键里程碑.
- 分析AC目前的治疗选择,重点是平衡瘤控制和QoL.
主要方法:
- 关于AC治疗的相关文献的综述.
- 历史 (侵略性手术) 和最近 (综合管理) 个人患者系列的比较.
- 对结果的分析,包括复发率,死亡率,存活率和长期发病率.
主要成果:
- 确定了三个不同的AC管理时代:库希时代,显微镜时代和当前的综合治疗期.
- 目前的综合管理方法 (手术加辅助疗法) 显示,整体存活率和瘤控制率与历史上的侵略性手术相比相当.
- 与积极的手术相比,综合管理显著降低了手术后的泛阴垂体病,肥胖和视力恶化率.
结论:
- 虽然激进手术提供了良好的AC控制,但它具有永久性致病率的高风险.
- 更保守的综合治疗政策可以改善QoL结果,而不会影响瘤控制或生存.
- 内镜技术,质子疗法和囊管理方面的进步促进了这种改善的QoL.
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