第四脑室室管膜瘤切除后不同范围化疗的疗效比较

Combined treatment and prognosis of ependymoma in fourth ventricle of the brain

目的总结儿童第四脑室室管膜瘤的外科治疗经验,探讨其综合治疗的效果.方法全组35例,均采用显微外科手术切除第四脑室室管膜瘤,术后2～3周25例实施全脑全脊髓加局部放疗;8例仅作局部放疗;2例未作放疗.结果全切肿瘤20例,次全切除15例,无手术死亡.术后恢复良好20例,轻残10例,重残5例.全切肿瘤组、次全切组,全脑全脊髓加局部放疗组、局部放疗组及未放疗组5年生存率分别为90.0%（18/20）、6.6%（1/15）、88.0（22/25）、62.5%（5/8）和0.结论手术治疗儿童第四脑室室管膜瘤能获得良好的效果,全切肿瘤及术后全神经轴加局部放疗能延长患者生存时间.

Objective To summarize experience of the combined treatment of ependymoma in fourth ventricle of the brain of child and to study improvement of effect of the operation plus radiotherapy. Methods 35 cases with ependymoma in fourth cerebral ventricle were treated with microneuro-surgical resection. Among the 35 cases, 25 were treated with total brain and spinal cord plus local focus radiotherapy within 2 to 3 weeks after operation;8 only with local focus radiotherapy,2 cases were not done with radiotherapy. Results Total removal of tumors was done in 20 cases,subtotal removal in 15 cases, and no patient died from operation. After operation,20 patients had a good recovery,10 had a light disability, and 5 needed assistance. The 5-year survival rate were 90.0% （18/＇20）, 6.6%（1/15） ,88.0（22/25）,62.5% （5/8） and 0% ,in different group respectively. Conclusion Surgical treatment is obviously effective to ependymoma in fourth ventricle of the brain and total removal of tumors combined with radiotherapy is aid to extend the patient＇s survival time.