髓母细胞瘤54例临床分析  

A clinical study on medulloblastoma in 54 patients

作　　者：郭文杰[1] 朱军[1] 冯平柏[1] 许康雄[1] 

机构地区：[1]江苏省肿瘤医院放疗科,南京210009

出　　处：《肿瘤防治研究》2003年第2期138-140,共3页Cancer Research on Prevention and Treatment

摘　　要：目的　回顾分析髓母细胞瘤的临床特点 ,探讨合理治疗方案及影响预后的因素。方法　 1979年 12～ 1998年 12月 ,本科收治髓母细胞瘤 5 4例 ,男 35例 ,女 19例 ,年龄 2 .5～ 2 3.0岁 ,中位年龄 9岁。全部病例先经手术切除 ,(2 5例肉眼全切除 ,2 9例次全切除或部分切除 ) ,病理证实为髓母细胞瘤。术后均接受全脑、全脊髓放射治疗。 32例后颅窝剂量≥ 5 0Gy。 2 2例后颅窝剂量 <5 0Gy。 结果　全部病例 1、3、5和 10年生存率分别为 86 .9%、5 8.8%、5 5 .5 %和 4 8.3%。其中 12例放疗后复发 ,1例放疗后远处转移 (经病理证实 )。多因素分析显示照射剂量 (<) 4 5Gy分组时手术切除程度 (即有无残留 )以及肿瘤部位均对预后有影响(P值分别为 0 .0 2 5和 0 .0 4 9)。剂量 (≤ ) 5 0Gy分组时仅手术切除程度对预后有影响 (P =0 .0 4 3) ,但P值趋大。结论　髓母细胞瘤首选手术 ,术后全脑、全脊髓放射治疗的方法是神经外科及放射治疗医师共同推荐的治疗方案 ,对肿瘤未能完整切除者 ,可通过增加局部放射治疗剂量改善生存。Objective To review the clinical characteristics of medulloblastoma and discuss the reasonable plan of the treatment and the related prognostic factors. Methods 54 cases were treated in our hospital from Dec.1979 to Dec.1998. All cases were operated before radiotherapy and were pathologically confirmed to be medulloblastoma. All patients received systematic craniospinal irradiation with 22 patients received posterior fossa irradiation to a total dose lower than 50 Gy, and 32 cases over 50 Gy . Results The overall 1, 3, 5, 10 years survival rates were 86.9%, 58.5%, 55.5% and 48.3% respectively. Cox regression analyses showed that the resection ( P =0.043) were statistically influenced the prognosis only at the group of 50Gy. Conclusion Both neurosurgeon and radiotherapist were in favor of the plan of operation followed by post operative irradiation of craniospinal in the treatment of medulloblastoma. Higher dose(≥50Gy) irradiation to the lesion, which is not total excisied, was probably a key factor for the survival.

关 键 词：髓母细胞瘤 临床分析 放射疗法 外科手术 治疗 

分 类 号：R739.41[医药卫生—肿瘤] R730.5[医药卫生—临床医学]