原发性颅内生殖细胞肿瘤的诊断和治疗
连欣;张福泉;
摘要(Abstract):
<正>颅内生殖细胞肿瘤(intracranial germ cell tumors)按病理类型大体可分为生殖细胞瘤(germinoma)、非生殖细胞性生殖细胞肿瘤(non-germinomatous germ cell tumors,NGGCT)及多种成分的混合性肿瘤,其中生殖细胞瘤约占2/3。以往多认为颅内生殖细胞肿瘤在东亚地区发病率高于西方国家,但最新数据显示,其在以日本为代表的东亚地区年发病率与以美国为代表的西方国家相似(0.189/10万和0.148/10万),儿童及青少年是高发人群,男女发病率比约为
关键词(KeyWords):
颅内肿瘤;生殖细胞瘤;放射治疗;综合治疗
基金项目(Foundation):
作者(Author):
连欣;张福泉;
Email:
DOI:
参考文献(References):
- [1]McCarthy BJ,Shibui S,Kayama T,et al.Primary CNS germ cell tumors in Japan and the United States:an analysis of 4tumor registries[J].Neuro Oncol,2012,14:1194-1200.
- [2]Echevarria ME,Fangusaro J,Goldman S.Pediatric central nervous system germ cell tumors:a review[J].Oncologist,2008,13:690-699.
- [3]Shibamoto Y,Sasai K,Oya N,et al.Intracranial germinoma:radiation therapy with tumor volume-based dose selection[J].Radiology,2001,218:452-456.
- [4]Ogawa K,Toita T,Kakinohana Y,et al.Long-term results of radiotherapy for intracranial germinoma:a multi-institutional retrospective review of 126 patients[J].Int J Radiat Oncol Biol Phys J,2004,58:705-713.
- [5]Utsuki S,Oka H,Tanaka S,et al.Long-term outcome of intracranial germinoma with HCG elevation in cerebrospinal fluid but not in serum[J].Acta Neurochir,2002,144:1151-1155.
- [6]王作伟,王凯,王长春,等.颅内生殖细胞瘤患者血清β-HCG水平与预后相关性研究[J].中国临床神经外科杂志,2009,14:263-265.
- [7]Sawamura Y,Ikeda J,Shirato H,et al.germ cell tumors of the central nervous system:treatment considerations bases on111 cases and their long-term clinical outcome[J].Eur J Cancer,1998,34:104-110.
- [8]Rogers SJ,Mosleh-Shirazi MA,Saran FH,et al.Radiotherapy of localized intracranial germinoma:time to sever historical ties?[J].Lancet Oncol,2005,6:509-519
- [9]Shim KW,Kim TG,Suh CO,et al.Treatment failure in intracranial primary germinomas[J].Childs Nery Syst,2007,23:1155-1161.
- [10]Huang PI,Chen YW,Wong TT,et al.Extended focal radiotherapy of 30 Gy alone for intracranial synchronous bifocal germinoma:a single institute experience[J].Childs Nerv Syst,2008,24:1315-1321.
- [11]Lafay-Cousin L,Millar BA,Mabbott D,et al.Limited-field radiation for bifocal germinoma[J].Int J Radiat Oncol Biol Phys,2006,65:486-492.
- [12]Ogawa K,Yoshii Y,Shikama N,et al.Spinal recurrence from intracranial germinoma:risk factors and treatment outcome for spinal recurrence[J].Int J Radiat Oncol Biol Phys,2008,72:1347-1354.
- [13]Aydin F,Ghatak NR,Radie-Keane K,et al.The short-term effect of low-dose radiation on intracranial germinoma.A pathologic study[J].Cancer,1992,69:2322-2326.
- [14]Shim KW,Park EK,Lee YH,et al.Treatment strategy for intracranial primary pure germinoma[J].Childs Nerv Syst,2013,29:239-248.
- [15]Kanamori M,Kumabe T,Saito R,et al.Optimal treatment strategy for intracranial germ cell tumors:a single institution analysis[J].J Neurosurg Pediatr,2009,4:506-514.
- [16]Khatua S,Dhall G,O'Neil S,et al.Treatment of primary CNS germinomatous germ cell tumors with chemotherapy prior to reduced dose whole ventricular and local boost irradiation[J].Pediatr Blood Cancer,2010,55:42-46.
- [17]Chen YW,Huang PI,Ho DM,et al.Change in treatment strategy for intracranial germinoma:long-term follow-up experience at a single institute[J].Cancer,2012,118:2752-2762.
- [18]Paximadis P,Hallock A,Bhambhani K,et al.Patterns of failure in patients with primary intracranial germinoma treated with neoadjuvant chemotherapy and radiotherapy[J].Pediatr Neurol,2012,47:162-166.
- [19]Alapetite C,Brisse H,Patte C,et al.Pattern of relapse and outcome of non-metastatic germinoma patients treated with chemotherapy and limited field radiation:the SFOP experience[J].Neuro Oncol,2010,12:1318-1325.
- [20]Weksberg DC,Shibamoto Y,Paulino AC.Bifocal intracranial germinoma:a retrospective analysis of treatment outcomes in 20 patients and review of the literature[J].Int J Radiat Oncol Biol Phys,2012,82:1341-1351.
- [21]Calaminus G,Kortmann R,Worch J,et al.SIOP CNS GCT96:final report of outcome of a prospective,multinational nonrandomized trial for children and adults with intracranial germinoma,comparing craniospinal irradiation alone with chemotherapy followed by focal primary site irradiation for patients with localized disease[J].Neuro Oncol,2013,15:788-796.
- [22]Kretschmar C,Kleinberg L,Greenberg M,et al.Pre-radiation chemotherapy with response-based radiation therapy in children with central nervous system germ cell tumors:a report from the Children's Oncology Group[J].Pediatr Blood Cancer,2007,48:285-291.
- [23]Haas-Kogan DA,Missett BT,Wara WM,et al.Radiation therapy for intracranial germ cell tumors[J].Int J Radiat Oncol Biol Phys,2003,56:511-518.
- [24]Kim JW,Kim WC,Cho JH,et al.A multimodal approach including craniospinal irradiation improves the treatment outcome of high-risk intracranial nongerminomatous germ cell tumors[J].Int J Radiat Oncol Biol Phys,2012,84:625-631.