复杂难治性颅底肿瘤的精准治疗进展  

Advances in precision treatment of complex refractory skull base tumors

作　　者：王跃龙[1] 吴安华 屈延 陈菊祥 宫晔 赵元立 张军[7] 杨军[8] 杨刚[9] 唐晓平[10] 昝昕[1] 徐建国[1] WANG Yuelong;WU Anhua;QU Yan;CHEN Juxiang;GONG Ye;ZHAO Yuanli;ZHANG Jun;YANG Jun;YANG Gang;TANG Xiaoping;ZAN Xin;XU Jianguo(Department of Neurosurgery,West China Hospital,Sichuan University,Chengdu 610041,China;不详)

机构地区：[1]四川大学华西医院神经外科,成都610041 [2]中国医科大学附属盛京医院神经外科 [3]空军军医大学第二附属医院神经外科 [4]海军军医大学第一附属医院神经外科 [5]复旦大学附属华山医院神经外科 [6]北京协和医科大学附属协和医院神经外科 [7]解放军总医院神经外科 [8]北京大学第三人民医院神经外科 [9]重庆医科大学附属第一医院神经外科 [10]川北医学院附属医院神经外科

出　　处：《临床神经外科杂志》2025年第1期99-105,共7页Journal of Clinical Neurosurgery

基　　金：国家自然科学资金面上项目(82173175);四川省科技计划重点研发项目(2023YFS0105)。

摘　　要：复杂难治性颅底肿瘤的治疗因其解剖结构复杂、邻近重要神经血管而充满挑战。近年来,随着影像学技术、人工智能、手术方法及术后精准治疗的不断发展,颅底肿瘤的诊治取得了显著进步。本文系统综述了术前评估、手术治疗、术中精准识别和术后精准治疗的最新进展。术前,多模态影像结合人工智能技术显著提升了对肿瘤解剖结构和生物学特性的评估精度。手术方面,显微技术与内镜技术的结合进一步优化了手术策略,降低了手术相关风险;多学科协作模式在复杂病例中也展现了重要作用。术中,靶向荧光成像、术中导航和神经保护技术的发展有效提高了肿瘤切除率并减少了术后并发症。术后,放射治疗、靶向治疗和免疫治疗等精准治疗策略降低了复发率、提高了侵袭性颅底肿瘤的控制率。未来,随着精准医学和人工智能技术的深入应用,颅底肿瘤的治疗将更加个性化和高效,为患者提供更优的生存质量。The treatment of complex refractory skull base tumors poses significant challenges due to their intricate anatomical structures and proximity to critical neurovascular components.In recent years,advances in imaging technologies,surgical techniques,and postoperative precision therapies have led to remarkable progress in the diagnosis and management of skull base tumors.This review comprehensively summarizes recent developments in preoperative assessment,surgical treatment,intraoperative precision identification,and postoperative precision therapy.Preoperatively,multimodal imaging combined with artificial intelligence has significantly improved the accuracy of assessing the tumor's anatomical and biological characteristics.Surgically,the integration of microsurgical and endoscopic techniques has optimized strategies and reduced associated risks,with multidisciplinary collaboration proving crucial in complex cases.Intraoperatively,advancements in targeted fluorescence imaging,real-time navigation,and neuroprotection technologies have enhanced tumor resection rates while minimizing postoperative complications.Postoperatively,precision therapies such as radiotherapy,targeted therapy,and immunotherapy have notably improved control rates for recurrent and invasive skull base tumors.Looking ahead,the deeper application of precision medicine and artificial intelligence is expected to make the treatment of skull base tumors increasingly personalized and efficient,providing patients with better survival outcomes and quality of life.

关 键 词：复杂难治性颅底肿瘤 术前评估 手术治疗 术中精准识别技术 术后综合治疗 

分 类 号：R739.41[医药卫生—肿瘤]