儿童松果体区肿瘤的治疗策略  

The treatment role of childhood pineal region tumors

作　　者：黄翔[1] 张荣[1] 张超[1] 黄峰平[1] 

机构地区：[1]复旦大学附属华山医院神经外科,复旦大学上海医学院神经外科学系,上海200040

出　　处：《中华神经外科杂志》2013年第6期553-556,共4页Chinese Journal of Neurosurgery

摘　　要：目的探讨儿童松果体区肿瘤的临床特点与治疗策略。方法回顾性分析上海华山医院治疗的70例经病理证实的儿童松果体区肿瘤。根据手术方式和术后表现进行分析。结果男53例，女17例，年龄6—16岁。经病理证实生殖细胞肿瘤（包括生殖细胞瘤、畸胎瘤及其他恶性非生殖细胞瘤性生殖细胞肿瘤）47例，松果体细胞瘤6例，松果体母细胞瘤3例，星形细胞瘤3例，毛细胞型星形细胞瘤4例，其他类型肿瘤7例。所有病例均接受手术治疗，70例中，经小脑幕下小脑上人路37例，经枕下经小脑幕入路26例，经胼胝体一穹窿间入路4例，经胼胝体后部人路2例，颞部一侧脑室三角部入路1例。肿瘤全切除36例，次全切除18例，大部分切除16例。病理证实为恶性的病变术后行放疗和（或）化疗，9例术后并发脑积水行分流术，共随访到58例（83％），总的5年生存率为66％，术后KPS评分大于80分者53例（91％）。结论对于儿童松果体区肿瘤，影像学检查缺乏明确特征，病理检查是诊断金标准，手术治疗应为首选。明确病理后应实施个体化的治疗方案，最大限度地提高远期生存率。Objective To discuss the clinical features and the treatment of childhood intracranial tumors originating in the pineal region. Methods Tile records of 70 children treated in Shanghai Huashan Hospital who suffered from tumors arising from the pineal region, based on iconography, were reviewed retrospectively for their clinical characteristics, surgical approaches, and prognosis. Results In these 70 cases, there were 47 germ cell tumors, 6 pineoblastoma, 3 pineocytoma, 3 astrocytoma, 4 pilocytic astrocytoma, and 7 other tumors. All patients were treated surgically. The tumor was totally removed in 36 cases, sub-totally in 18, and partially in 16. Nine patients received by-pass surgery because of hydrocephalus after tumor resection. 58 patients （83%） were successfully followed up. The common 5-year survival rate was 66%, and the KPS scores were more than 80 in 53 cases（91% ）. Conclusions Surgery was an effective treatment for pineal region tumors. A suitable approach, position, and skilled microsurgical techniques played key roles in the treatment of pineal region tumors.

关 键 词：松果体区 脑肿瘤 治疗 

分 类 号：R739.4[医药卫生—肿瘤]