儿童小脑星形细胞瘤的术后放疗

POSTOPERATIVE RADIOTHERAPY FOR CEREBELLAR ASTROCYTOMA IN THE CHILDREN

１９７７年２月至１９９０年２月，术后放疗儿童小脑星形细胞瘤３１例。３、５及１０年生存率分别为８０．６％、７１．４及６３．６％。部分切除术组的３及５年生存率均比近全切除术组的低（Ｐ＜０．０５）。肿瘤侵入脑干者的３年生存率比未侵入的明显低（Ｐ＜０．０１）；前者的５年生存率也比后者的低（Ｐ＜０．０５）。术后放疗４５～５５Ｇｙ组与５５．１～６０Ｇｙ组比较：生存率无差别，生存质量增高，但无统计学差异。我们建议对儿童小脑星形细胞瘤未行全切术者应给予术后放疗。

Thirty-one children suffering from cerebellar astrocytomas were irradiated postoperatively from February 1977 to February 1990. The 3-, 5- and 10- year survival rates were 80 6%, 71 4% and 63 3%. Partial resection gave poorer 3- and 5- year survivals than subtotal resection (P<0 05). Those with the brain stem invaded did poorer result than those without(P<0 05). 45～55Gy gave similar survivals as compared with 55～60Gy, but the former lead to better quality of life (P<0 05). The authors believe that all childhood patients for whom complete resection was not done should be irradiated with doses of 40～55Gy/5～6wk. Bilateral opposing portals are preferred.