脑胶质肉瘤八例报告并文献复习

Brain gliosarcoma： 8 cases report and review of literatures

目的探讨胶质肉瘤的流行病学特点，及其发病机制、治疗、预后和放射与继发胶质肉瘤之间的关系。方法手术治疗8例胶质肉瘤，并结合文献进行分析。结果全部镜下手术切除，肿瘤全切5例，次全切3例。随访中7例发现肿瘤复发，2例出现颅内转移，6例因肿瘤复发在术后2年内死亡。8例中2例为继发性，均在原发肿瘤术后接受过放疗。结论胶质肉瘤是罕见的高度恶性肿瘤，其复发、转移率高，预后不良，尽可能完全切除肿瘤是首选治疗方案，对复发肿瘤再次手术为延长生存时间的最佳手段。放射治疗与继发胶质肉瘤之间可能存在着一定的因果关系。

Objective To discuss the epidemiological and clinical features of the gliosareoma and to explore its pathogenesis, treatment, prognosis and the relationship between radiotherapy and secondary gliosarcoma. Methods To report 8 cases of gliosareoma which was operated under microscope and do analysis by reviewing literatures. Results Total removal was achieved in 5 cases, and subtotal in 3 cases. Of all were followed up, tumor recurrence was found in 7 cases（ 87.5% ） , intracranial metastasis was found in 2 cases（25% ）, and 6 cases died due to recurrent gliosarcoma in 2 years after operation. 2 out of 8 were secondary gliosareoma, both received radiotherapy after operation of the primary tumors. Conclusion Gliosareoma which is a kind of rare malignant tumor, has high recurrent, metastatic rate and bad prognosis. To remove the tumor as completely as possible is the first therapeutic regimen, and re-operation is the best method to prolong the survival time when gliosarcoma recurs and general condition permits. Moreover, there may exist a cause and effect relationship between radiotherapy and the secondary gliosareoma.