[垂体神经内分泌肿瘤(垂体瘤)治疗的最新进展]。

Q4 Medicine Neurological Surgery Pub Date : 2024-05-01 DOI:10.11477/mf.1436204957
Hiroshi Nishioka
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引用次数: 0

摘要

在世界卫生组织 2022 年的分类中,将垂体腺瘤更名为垂体神经内分泌肿瘤(PitNET),以表示其罕见但可能是恶性的行为。目前还没有针对 PitNET 的分级系统;因此,建立一个符合其临床表现的系统是一个紧迫的问题。目前,这一变化对治疗策略没有直接影响。近来,由于手术和药物治疗的显著进步,大多数颅内憩室网患者的治疗效果都有了明显改善。前者包括内窥镜手术的发展和技术的改进,后者则包括新的有效药物的引入以及使用这些药物的知识和经验的增加,从而导致了个性化和/或精准医疗的出现。因此,治疗目标也在不断进步,包括内分泌缓解、成功控制合并症、提高与健康相关的生活质量和正常化死亡率。然而,一些侵袭性和转移性PitNETs的治疗仍然困难重重。尽管替莫唑胺(TMZ)被认为是一种很有前景的唯一治疗方案,但最近的报告显示,在许多病例中,TMZ并不能提供长期的控制效果。要对侵袭性肿瘤进行可靠的预测和成功的治疗,必须采用多学科方法。
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[Recent Progress in Treatments of Pituitary Neuroendocrine Tumors(Pituitary Tumors)].

In the World Health Organization 2022 classification, a nomenclature change from pituitary adenoma to pituitary neuroendocrine tumor(PitNET)was introduced to indicate rare but potentially malignant behavior. No grading system is available for PitNETs; therefore, the establishment of a system that corresponds to their clinical behavior is an urgent issue. Presently, this change has no direct influence on therapeutic strategies. Recently, the therapeutic outcomes of most patients with PitNETs have significantly improved owing to marked advancements in both surgical and medical treatments. The former includes the evolution of endoscopic surgery and technical refinements, whereas the latter includes the introduction of new effective drugs and increased knowledge and experience regarding their use, leading to personalized and/or precision medicine. Consequently, the treatment goals have advanced, encompassing endocrinological remission, successful management of comorbidities, increased health-related quality of life, and a normalized mortality rate. However, management of some aggressive and metastatic PitNETs remains difficult. Although temozolomide(TMZ)is considered a promising sole therapeutic option, recent reports have shown that TMZ does not provide long-term control in many cases. A multidisciplinary approach is necessary for the reliable prediction and successful management of aggressive tumors.

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来源期刊
Neurological Surgery
Neurological Surgery Medicine-Medicine (all)
自引率
0.00%
发文量
99
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