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复发颅咽管瘤的诊疗进展
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Abstract:
颅咽管瘤虽然在组织学上展现出良性特征，然而，由于其生长位置极为特殊，紧邻众多关键的神经和内分泌结构，导致其治疗效果常常未能达到预期，复发率居高不下，成为了神经外科领域内亟待解决的一大挑战。其复发机制错综复杂，深受多种因素影响，其中，手术过程中是否能够实现全切、肿瘤的病理学类型以及术后是否采取了有效的辅助治疗措施，均扮演着至关重要的角色。针对复发性颅咽管瘤，目前的治疗方法主要包括外科手术、放射治疗和化疗等。本文系统综述复发颅咽管瘤的复发原因分析、影像诊断、治疗策略。
Despite exhibiting histologically benign characteristics, craniopharyngiomas pose significant clinical challenges in neurosurgical practice owing to their critical anatomical proximity to vital neuroendocrine structures, frequently resulting in suboptimal therapeutic outcomes and persistently high recurrence rates. The pathogenesis of tumor recurrence involves multifactorial determinants, with gross total resection (GTR) during primary surgery, histopathological subtypes, and implementation of postoperative adjuvant therapies serving as pivotal prognostic modifiers. Current therapeutic modalities for recurrent craniopharyngioma encompass surgical reintervention, radiotherapy (RT), and chemotherapy (CT). This article systematically reviews the etiologic analysis of recurrence, radiographic diagnostics, and evolving therapeutic approaches for recurrent craniopharyngioma.
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