原发性脊髓胶质母细胞瘤的显微外科治疗及预后  

Microsurgical management and prognosis of primary spinal cord glioblastoma

作　　者：韩波[1] 刘东康[1] 孔德生[1] 杨俊[1] 徐宇伦[1] 王劲[2] 王贵怀[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经外科,100050 [2]首都医科大学北京市神经外科研究所

出　　处：《中华神经外科杂志》2014年第7期674-676,共3页Chinese Journal of Neurosurgery

摘　　要：目的探讨原发性脊髓胶质母细胞瘤的外科治疗方法及预后。方法回顾性分析经外科手术治疗的15例原发性脊髓胶质母细胞瘤患者的临床资料。结果15例患者中，大部分切除5例，部分切除10例。14例患者术后采用放疗和（或）化疗。经随访，所有患者均死亡，死因明确者11例，其中3例死于术后并发症，8例死于脊髓及脑转移。整体患者中位生存时间为11个月，大部切除组与部分切除组患者中位生存时间分别为为12个月与11个月。应用Log—rank检验得出两组之间生存率差异无统计学意义（P〉0．05）。结论原发性脊髓胶质母细胞瘤为高侵袭性及高度恶性疾病，临床罕见，易复发和转移，预后极差；手术的目的是明确病理诊断，减少肿瘤负荷，改善压迫症状。术后联合放疗、化疗等综合措施以提高患者的牛存质量和延长牛存期。Objective To explore the microsurgical management and prognosis of primary intramedullary glioblastoma. Methods The clinical datas of 15 patients with primary intramedullary glioblastoma who accepted microsurgical treatment were analyzed retrospectively. Results Mostly resection was performed in 5 cases, and partial resection in 10. 14 patients were treated with postoperative radiotherapy and/or chemotherapy. All patients died during the follow - up period. 3 of 11 cases with clear cause of death died of postoperative complications, 8 cases died of spinal cord and brain metastases. By Kaplan - Meier analysis, the median survival for all patients, Mostly resection subgroup and partial resection subgroup was 11 months, 12 months and 11 months, respectively. The difference in the survival duration between mostly and partial resection did not reach statistical significance （P 〉 0.05 ）. Conclusions Primary spinal glioblastoma is a rare disease, with an aggressive course and poor prognosis. The purpose of operation is to confirm the pathologic diagnosis, reduce tumor burden, and relieve the symptoms. An aggressive comprehensive treatment （such as postoperative radiotherapy, chemotherapy protocols） should be performed to extend the patient＇s survival duration with better quality of life.

关 键 词：胶质母细胞瘤 脊髓 原发性 外科治疗 预后 

分 类 号：R739.4[医药卫生—肿瘤]