侵犯颅底区域肿瘤的治疗和预后探讨

Study of Managment and Prognosis on the Tumors Involving Skullbase

本研究回顾性分析了1979年至1995年间经治的30例侵犯颅底的肿瘤病例。除了3例失去手术指征采用单纯化疗或放疗外，其余27例均采取手术治疗，肿瘤切除后边缘用液氮冷冻处理，术后辅以放疗。30例均获随访，3例未手术者分别在以后的1～4年内死亡。手术的27例，死亡9例，3年和5年生存率分别为63．5％，564％。作者认为：对不明原因的张口受限及颌后深部肿块应引起高度重视；CT及MRI对依底肿瘤有较高的诊断价值；正确的手术进路，安全边界的冷冻处理及术后放疗可改善预后。

Purpose: To study early diagnosis on tumors involving skullbase, approach for the operation. management methods and the prognosis. Method: A retrospective analviis of 30 cases with the tumors involving skullbase from 1979 to 1995 was carried out. 27 cases had obtained surgical treatment and cryotherapy with liquld nitrogen during operation or radiation after operation as well as 3 cases who had lost opportunity of surgery.Result:All of 30 cases had been followed up. Three unoperated died during later four years and only nine were dead among 27 operated cases. The 3 and 5 year cure rates were 63. 5 % and 56. 4% respectively. Condusion: Indefinite lirnit to mouth open and deep swell located posterior mandible should be cautioned. CT and MRI have a great value on diagnosis of the tumors involving skullbase. Prognosis could be greatly improved with preferable smpical metheds,cryotherapy on the periphery of tumors with liquid nittogen during operation and radiotherapy after operation.