中华神经科杂志
中華神經科雜誌
중화신경과잡지
Chinese Journal of Neurology
2013年
7期
470-473
,共4页
赵赋%渠沛然%张晶%王振民%王兴朝%杨智君%刘丕楠
趙賦%渠沛然%張晶%王振民%王興朝%楊智君%劉丕楠
조부%거패연%장정%왕진민%왕흥조%양지군%류비남
髓母细胞瘤%小脑肿瘤%神经外科手术%放射疗法%预后%成年人
髓母細胞瘤%小腦腫瘤%神經外科手術%放射療法%預後%成年人
수모세포류%소뇌종류%신경외과수술%방사요법%예후%성년인
Medulloblastoma%Cerebellar neoplasms%Neurosurgical procedures%Radiotherapy%Prognosis%Adult
目的 探讨成人髓母细胞瘤(MB)的治疗方式及预后.方法 筛选经手术及病理证实为MB的成人患者163例,回顾性分析其临床表现、影像学、治疗方式及预后特点.其中包括男性108例,女性55例,平均28.6岁.结果 患者临床表现主要有头痛、恶心及呕吐、头晕、步态不稳、视力减退、复视、听力下降、小脑危象等.术后肿瘤全切90例,近全切67例,部分切除6例.共随访患者160例,其中生存121例,死亡39例,生存时间为7 ～ 170个月,中位生存期(127 ±6)个月(95％ CI115.3～ 138.7),5年生存率73.1％(120/163).接受全脑-脊髓放疗患者组与全脑或局部放疗患者组生存期比较,差异具有统计学意义(中位生存时间分别为44个月和34个月,x2=8.712,P=0.003).结论 手术切除结合早期足量的全脑-脊髓放疗可有效治疗成人MB,肿瘤复发和转移是造成患者预后差的主要因素.
目的 探討成人髓母細胞瘤(MB)的治療方式及預後.方法 篩選經手術及病理證實為MB的成人患者163例,迴顧性分析其臨床錶現、影像學、治療方式及預後特點.其中包括男性108例,女性55例,平均28.6歲.結果 患者臨床錶現主要有頭痛、噁心及嘔吐、頭暈、步態不穩、視力減退、複視、聽力下降、小腦危象等.術後腫瘤全切90例,近全切67例,部分切除6例.共隨訪患者160例,其中生存121例,死亡39例,生存時間為7 ～ 170箇月,中位生存期(127 ±6)箇月(95％ CI115.3～ 138.7),5年生存率73.1％(120/163).接受全腦-脊髓放療患者組與全腦或跼部放療患者組生存期比較,差異具有統計學意義(中位生存時間分彆為44箇月和34箇月,x2=8.712,P=0.003).結論 手術切除結閤早期足量的全腦-脊髓放療可有效治療成人MB,腫瘤複髮和轉移是造成患者預後差的主要因素.
목적 탐토성인수모세포류(MB)적치료방식급예후.방법 사선경수술급병리증실위MB적성인환자163례,회고성분석기림상표현、영상학、치료방식급예후특점.기중포괄남성108례,녀성55례,평균28.6세.결과 환자림상표현주요유두통、악심급구토、두훈、보태불은、시력감퇴、복시、은력하강、소뇌위상등.술후종류전절90례,근전절67례,부분절제6례.공수방환자160례,기중생존121례,사망39례,생존시간위7 ～ 170개월,중위생존기(127 ±6)개월(95％ CI115.3～ 138.7),5년생존솔73.1％(120/163).접수전뇌-척수방료환자조여전뇌혹국부방료환자조생존기비교,차이구유통계학의의(중위생존시간분별위44개월화34개월,x2=8.712,P=0.003).결론 수술절제결합조기족량적전뇌-척수방료가유효치료성인MB,종류복발화전이시조성환자예후차적주요인소.
Objective To analyze the clinical manifestations,treatment and prognosis of adult medulloblastoma (MB).Methods A total of 163 cases of adult MB,confirmed by surgical and pathological diagnosis,were retrospectively analyzed about the clinical manifestations,imaging,treatment and prognosis.There are 108 males and 55 females in the group,whose average age was 28.6-year-old.Results The main clinical manifestations include headache,nausea,vomiting,dizziness,gait disturbance,hypopsia,diplopia,hearing loss and cerebellum crisis.Gross total resection was achieved in 90 cases,subtotal resection in 67 cases and biopsy in 6 cases.Survival time from surgery to progression or death or the last date of follow-up were measured and estimated by the Kaplan-Meier method.Among a total of 160 follow-up patients with MB,postoperative overall survival time was from 7 to 170 months,median survival time was (127±6) months (95％ CI 115.3-138.68).The 5-year overall survival time of adult MB patients was 73.1％ (120/163).The log-rank test was used to compare the significance of the following prognostic variables.Among all clinical factors,patients undergoing the craniospinal irradiation had a significantly better survival rate than those without this treatment (44 months vs 34 months,x2 =8.712,P =0.003).Conclusion Good therapeutic effect of MB be achieved by adopting surgical resection with early enough craniospinal irradiation.Recurrence and metastasis are the two main factors for bad prognosis in adult MB.
