小儿晚期恶性脑肿瘤的治疗

Treatment of Children with Advanced Malignant Brain Tumor

目的:探讨45例小儿可治性晚期脑肿瘤(髓母细胞瘤,星型细胞瘤,室管膜细胞瘤)的治疗方案及30例小儿难治性晚期恶性脑肿瘤(生殖细胞瘤,脑干肿瘤)的治疗转归。方法:可治性肿瘤中30例采用自身骨髓移植方案,15例采用强化疗方案;难治性肿瘤中13例采用自身骨髓移植方案,17例采用强化疗方案。结果:可治性肿瘤中30例采用自身骨髓移植方案,5年生存率达43.33%;15例采用强化疗方案仅能提高中位生存期,不能提高5年生存率。难治性肿瘤中13例采用自身骨髓移植方案,17例采用强化疗方案,均于20个月内死亡。结论:小儿晚期恶性脑肿瘤可治性组,采用自身骨髓移植方案优于强化疗方案,更优于其他化疗方案。对小儿难治性晚期恶性脑肿瘤采用自身骨髓移植方案及强化疗方案均能延长中位生存期。

Objective:To study the treatment for curable advanced brain tumors(medulloblas- toma,astrocytoma,epondymoma)and the prognosis of incurable brain tumors(germinoma,brain stem tumors)among children.Methods:The automarrow transplantation was performed in 30 curable cases and intensive chemotherapy was given in the other 15 incurable cases.The automar- row transplantation was done in 13 incurable cases and intensive chemotherapy was given to the rest 17 incurahle cases.Results:43.33% of the 33 curable cases treated with automarrow trans- plantation survived over 5 years while the intensive chemotherapy alone only prolonged a limited survival time in the others.On the contrary,all the incurable children,no matter how the therapy being adopted,died within 20 months.Conclusion:In incurable cases,the automarrow transplan- tation is superior to the intensive chemotherapy and much better than other therapies.Both au- tomarrow transplantation and intensive chemotherapy are able to prolong a limited survival time for incurable brain tumors.