颅内多发性脑膜瘤的治疗对策

Treatment Strategy of Multiple Intracranial Meningiomas

目的探讨颅内多发性脑膜瘤(MIM)的临床特征和治疗对策。方法本组19例,男4例,女15例。全组病人经神经影像学检查诊断为MIM,肿瘤数目2～15个,平均3.7个;肿瘤大小1.0㎝×0.8㎝×1.0㎝～10㎝×8㎝×5㎝。采用个体化手术方案,其中行手术切除+立体定向放射外科治疗8例,手术切除+放疗6例,手术切除主要病灶+临床观察5例。结果随访6个月至9.5年,平均3.2年。存活14例,死亡5例(26.3%)。结论对MIM的治疗方法选择,要依据患者病灶部位、大小及对神经损害状态和程度,采用个体化治疗方案。

Objective To explore the clinical features and treatment strategy of the multiple intraeranial meninglomas （MIM）. Methods Of 19 patients who had 70 intraeranial meningiomas, 4 were mate and 15 female. The diagnosis of MIM was made by neuroimaging examination. The tumor number ranged from 2 to 15 and the tumor size ranged from 1.0cm×0.8cm×1.0cm to 10cm×8cm×5cm in the patients. The individualized plan to treat MIM was performed in all the patients. Of 19 patients with MIM, 8 were treated by microsurgery and stereotaetic radiosurgery, 6 by mierosurgery and radiotherapy, and 5 only by mierosurgery by which main lesions were removed. Results Following up from 6 months to 9.5 years showed that 14 survived and 5 died （26.3%, 5/19）. Conclusions The choice of the methods to treat MIM depends upon the number, size and location of the tumors, as well as situation of the damage to the neural function. The individualized treatment plan should be adopted in the patients with MIM.