Craniopharyngioma: a comparison of tumor control with various treatment strategies
Craniopharyngioma: a comparison of tumor control with various treatment strategies
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DOI：
10.3171/2010.1.focus09307
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发表时间：
2010-04-01
影响因子：
4.1
通讯作者：
Parsa, Andrew T.
中科院分区：
文献类型：
--
作者：
Yang, Isaac;Sughrue, Michael E.;Parsa, Andrew T.
物体。颅咽管瘤有切除后复发的倾向，可能通过其关键起源部位的侵袭性局部行为而导致死亡。最近的数据表明，次全切除(STR)加辅助放射治疗(XRT)可能是一种有吸引力的替代大部全切除(GTR)的方法，在提供相似的肿瘤控制率的同时，没有与积极切除相关的并发症。在这里，作者总结了已发表的关于颅咽管瘤不同治疗方式的肿瘤控制率的文献。作者对英文文献进行了全面的检索，以确定发表了颅咽管瘤手术患者结果数据的研究。Kaplan-Meier分析确定无进展生存率(PFS)和总生存率(OS)。有442例患者接受了肿瘤切除。其中GTR256例(58%)，STR101例(23%)，STR+XRT 85例(19%)。GTR组和STR+XRT组的2年和5年PFS率分别为88%和91%，67%和69%。GTR组和STR+XRT组的5年和10年OS率分别为98%和99%，98%和95%。PFS(LOG-RANK检验)和OS与GTR(LOG-RANK检验)差异无统计学意义。鉴于颅咽管瘤的相对少见，这项研究提供了各种治疗组合的结果估计，因为并不是所有的治疗方法都适用于所有患有这些肿瘤的患者。(DOI：10.3171/2010.1.FOCUS09307)
Object. Craniopharyngiomas have a propensity to recur after resection, potentially causing death through their aggressive local behavior in their critical site of origin. Recent data suggest that subtotal resection (STR) followed by adjuvant radiotherapy (XRT) may be an appealing substitute for gross-total resection (GTR), providing similar rates of tumor control without the morbidity associated with aggressive resection. Here, the authors summarize the published literature regarding rates of tumor control with various treatment modalities for craniopharyngiomas.Methods. The authors performed a comprehensive search of the English language literature to identify studies publishing outcome data on patients undergoing surgery for craniopharyngioma. Rates of progression-free survival (PFS) and overall survival (OS) were determined through Kaplan-Meier analysis.Results. There were 442 patients who underwent tumor resection. Among these patients, GTR was achieved in 256 cases (58%), STR in 101 cases (23%), and STR+XRT in 85 cases (19%). The 2- and 5-year PFS rates for the GTR group versus the STR+XRT group were 88 versus 91%, and 67 versus 69%, respectively. The 5- and 10-year OS rates for the GTR group versus the STR+XRT group were 98 versus 99%, and 98 versus 95%, respectively. There was no significant difference in PFS (log-rank test) or OS with GTR (log-rank test).Conclusions. Given the relative rarity of craniopharyngioma, this study provides estimates of outcome for a variety of treatment combinations, as not all treatments are an option for all patients with these tumors. (DOI: 10.3171/2010.1.FOCUS09307)