颞叶内侧低级别胶质瘤的个体化治疗

Individualized treatment to the medial temporal region glioma

目的探讨颞叶内侧低级别胶质瘤的综合治疗方法,评价其疗效。方法回顾性分析25例经手术证实的颞叶内侧低级别胶质瘤综合治疗的资料。结果25例颞叶内侧胶质瘤患者中,镜下近全切并术后影像学检查证实23例,大部切除2例。术后无偏瘫失语。随访3-48个月,3例复发,余未见复发及明显神经功能障碍。结论手术切除肿瘤仍然是颞叶内侧低级别胶质瘤首选治疗方法。恰当的手术入路,术前应用FMRI检查、术中电生理监测等对功能区及周围重要结构的精确辨认和保护以及术后放、化疗的合理应用是提高疗效的关键。

Objective To discuss treatment glioma on the medial temporal region and to evaluate its therapeutic outcome.Methods Retrospective analysis was adopted to evaluate 25 cases that underwent microsurgery on the medial temporal region glioma patients,and therapeutic experience was summarized.Results Among 25 patients,23 total excision,2 subtotal excision under microscope were confirmed by imaging technique postoperatively.There were no hemiparalysis.During the 3-48months follow-up,there was no more recurrence or conspicuous neurological dysfunction except 3 recidivation.Conclusion Microsurgical total excision is the first choice to treat the wall of temporal lobe glioma.Appropriate approach,preoperative FMRI examination,intraoperative electrophysiological monitoring,precise identify and protect of the functional area and vicinal important structures,pertinent radiotherapy and postoperative chemotherapy are all keys to improve the therapeutic efficacy.