幕上恶性胶质瘤术后异位复发的多因素临床分析（附8例临床报告）  

Clinical Experience of Dissemination and Metastasis of Supratentorial High Grade Glioma after Surgery

作　　者：傅强[1] 高志宇[1] 林凯[1] 王东臣[1] 祝子鹏[1] 孙汉宇[1] 刘超[1] 张杰[2] 

机构地区：[1]聊城市人民医院神经外科,山东聊城252000 [2]聊城市人民医院病理科,山东聊城252000

出　　处：《中华临床医师杂志（电子版）》2016年第7期1-3,共3页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的 研究幕上恶性脑胶质瘤患者手术后出现异位复发和播散转移的相关影响因素.方法 对已发现的幕上恶性胶质瘤异位复发和播散转移8 例病例进行回顾性临床分析,探讨其发生发展规律.并研究患者年龄、肿瘤性质、原发部位部位、手术方式、综合治疗、发生时间等与种植转移有联系的相关因素.结果 8 例中,6 例为胶质母细胞瘤,2 例为星形细胞瘤Ⅲ级,5 例手术中将脑室打通,所有病例术后均行标准化同步放化疗及替莫唑胺六周期维持化疗.在数月内发生同侧或对侧的脑室旁亦或远隔部位肿瘤种植性转移导致病情恶化.结论 幕上脑胶质瘤种植性播散转移多发生于青壮年恶性胶质瘤患者术后6 个月～1 年内,与同时行替莫唑胺同步放化疗且和术中打通脑室有密切关系,故类似患者术后1 年内应在较短的时间间隔内进行颅脑MRI 增强扫描,以尽可能早地发现复发和播散,从而调整治疗方案,以改善脑胶质瘤患者的预后.Objective To investigate the cases with ectopic recurrence and metastases of brain glioma after surgery and their related influencingfactors. Method we proceeded a retrospective clinical analysis of 8 patients that surffering recrudescent or transferred glioma, and then, we explored thepattern of development. In addition, the correlative factors on implantation metastasis were also in rearch, such as the patients’ age, the property of tumor,the primary position, the surgical method, comprehensive treatment, the medical surgery and so on. Results In the 8 clinical cases, 6 patients sufferedglioblastoma, 2 patients got astroglioma （level 3）, and 5 patients’ encephalocoele were opened during operation. All the patients received temozolomideand concurrent radiochemotherapy, but the ipsilateral or contralateral metastasis beside the ventricle or remoteness places exacerbated their condition.Conclusions implantation metastasis of supratentorial glioma mainly occurs in young adults 6 months- one year after the operation. And it has a closerelationship with the openness of lateral ventricle and treatment of temozolomide concurrent radiochemotherapy. In conclusion, the patients with similarcharacters should take cerebral MRI enhancement scanning in the next year of resection operation to discover recurrence and metastases as early aspossible, and then we can adjust treatment plans to improve prognosis of glioma.

关 键 词：幕上恶性胶质瘤 播散 转移 替莫唑胺同步放化疗 

分 类 号：R739.41[医药卫生—肿瘤]