儿童颅内生殖细胞肿瘤的治疗:天坛经验

Treatment of pediatric intracranial germ cell tumors:Tiantan experience

儿童颅内生殖细胞肿瘤是临床少见但高度异质性肿瘤,主要发生于儿童和青少年,治疗方法取决于肿瘤类型,单纯生殖细胞瘤经放化疗可治愈、成熟型畸胎瘤经手术切除可治愈,非生殖细胞瘤性生殖细胞肿瘤(NGGCT)则需综合治疗。目前国内外指南或专家共识均建议先予以药物化疗,未达完全缓解者再手术切除。然而临床实践中发现药物化疗后手术风险增加,故部分学者主张直接手术。首都医科大学附属北京天坛医院提出儿童颅内NGGCT临床诊疗策略(2023天坛版),建议由神经外科医师和肿瘤科医师共同评估,个体化治疗,为患儿提供更好的治疗方案。

Pediatric intracranial germ cell tumors(GCT)are clinically rare but highly heterogeneous tumors,primarily occurring in children and adolescents.The treatment method depends on the tumor type.Pure germinoma can be cured with radiotherapy and chemotherapy,while mature teratomas can be cured with surgical resection.Non⁃germinomatous germ cell tumors(NGGCT)require comprehensive treatment.Current domestic and international guidelines or expert consensus recommend initial chemotherapy,followed by surgical resection for those not achieving complete remission.However,clinical practice has found that surgery risks increase after chemotherapy,leading some experts to advocate for direct surgery.Beijing Tiantan Hospital,Capital Medical University proposed a clinical diagnosis and treatment strategy for pediatric intracranial NGGCT(2023 Tiantan version),recommending joint evaluation by neurosurgeons and oncologists for individualized treatment to provide better treatment plans for children.