颅底脊索瘤的治疗进展  

Advances in the Treatment of Skull Base Chordomas

作　　者：柳义夫[1] 杨义[1] 

机构地区：[1]中国协和医科大学中国医学科学院北京协和医院神经外科,北京100005

出　　处：《中国神经肿瘤杂志》2006年第3期187-191,共5页Chinese Journal of Neuro-Oncology

摘　　要：脊索瘤(chordoma)是来源于原始脊索组织的肿瘤,其发生部位也多见于残余脊索常见部位即骶尾部(50%)、颅底斜坡区(35%)及椎体(15%)。本文主要复习了颅底脊索瘤,重点讨论其手术治疗和放射治疗的适应证、治疗时机和疗效。通过复习国内外近期文献报道,我们认为,尽管脊索瘤的生物学行为及其治疗存在很多争论,争取根治性切除,术后辅以质子束放疗是目前最佳治疗方案。Chordomas are rare tumors originating from the remnants of the primitive notochord. Their deep location and patterns of extension and the proximity of structures such as the brain stem, upper cervical spine, hypophysis, and cranial nerves make their treatment a chaLlenge. During the past decade, several new surgical approaches and new modalities of radiation therapy have been developed for treating these lesions. In this review, the diagnosis and management of skull base chordomas are discussed, with emphasis on radical surgery treatment with radiation therapy with heavy particles. Despite the absence of malignant pathologic findings, the uncertain behavior of some lesions makes the management of skull base chordomas a ＂no-man＂ s land.＂ A review of the current literature allows the conclusion that radical surgical removal associated with adjuvant radiation therapy with heavy particles is, up to now, the best way to treat chordomas of the skull base.

关 键 词：脊索瘤 颅底肿瘤 颅底手术入路 质子束放疗 

分 类 号：R739.41[医药卫生—肿瘤]