颅底颈椎脊索瘤12例临床及预后分析  

CLINICAL AND PROGNOSTIC ANALYSIS OF 12 PATIENTS WITH CHORDOMAS OF THE BASE OF SKULL AND CERVICAL SPINE

作　　者：郭灵[1] 王明龙[1] 詹志光[1] 陈应瑞[1] 

机构地区：[1]广东省人民医院放疗科,510060

出　　处：《中国现代医学杂志》1997年第3期6-7,14,共3页China Journal of Modern Medicine

摘　　要：1984年～1991年该科共收治颅底颈椎脊索病12例，其中颅底10例，颈椎2例。男性8例。全组平均年龄38．7岁。所有病例均行术后60Co放射治疗，颅底、颈椎平均剂量分别是52．2Gy／5．5周和40Gy／4～5周。4例行肉眼肿瘤全部切除术，6例行肿瘤不全切除术，2例行活检减压术。5、10年生存率分别是41．6％和28．5％。9例治疗后复发（75％），3例伴远处转移。复发是治疗失败的关键。远处转移少见，但存在远期的转移和复发，所以应长期随访。彻底的手术加本后放射治疗是最佳治疗手段。三维立体定向治疗计划系统指导的带电粒子（质子及氦氖离子）放射治疗已改善了该病的预后。From 1984 to 1991, 10 patients with chordomas at the base of the skull and 2 patients with chordomas of the cervical spine were treated in our hospital. Eight patients were male and 4 were female. The median age was 28. 7 years. All patients underwent postoperative 60Co radiation therapy with a median dose of 52. 2Gy/5. 5w of chordomas of the base of skull and 40Gy/4-5w of the cervical spine. Four patients underwent gross totaI resection, 6 underwent incomplete resection, and 2 underwent biopsy only. The 5-10 year survival rate was 41. 6 % and 28. 5 % respectively. 9 of 12 patients recurred locally, among which 3 also developed distant metastasis. Local relapse was the predominant type of treatment failure. Patients should be followed up for a long period of time because of longterm recurrence and distant metastasis. Primary radical surgery plus postoperative radiation therapy is the optimal treatment approach. Newer radiotherapeutic approaches have allowed increased dose delivery to the target volume without an increase in radiation complication and have prolonged the patient's survival.

关 键 词：颅底脊索瘤 颈椎脊索瘤 手术 放射疗法 

分 类 号：R739.42[医药卫生—肿瘤]