颅内血管外皮细胞瘤的治疗及预后影响因素分析

Analysis of treatment and prognostic factors of intracranial hemangiopericytoma

目的探讨颅内血管外皮细胞瘤(HPC)的治疗方法及预后的影响因素。方法回顾性分析31例颅内HPC患者的临床资料,对其治疗方法及影响生存期的相关因素进行总结分析。结果 31例颅内HPC患者均行手术治疗;其中病变完全切除22例,非全切除9例(次全切除5例,大部分切除3例,部分切除1例),WHOⅡ级12例,WHOⅢ级19例。13例患者术后行分次外放射治疗,10例患者行γ-刀治疗。随访时间12~96个月,中位数为65个月。本组患者的5年无复发生存率为53.8%,中位无复发生存期(RFS)为65个月。全切组患者的中位RFS为76个月,非全切组患者的中位RFS为33个月;接受术后放疗患者的中位RFS为76个月,单纯手术患者为40个月;WHOⅡ级HPC患者的中位RFS为81个月,WHOⅢ级患者的中位RFS为40个月;以上两组间分别两两相比,差异均有统计学意义(均P<0.01)。结论全切肿瘤和术后辅助放射治疗可减低HPC原位复发率,延长患者RFS,是颅内HPC的有效治疗方案。

Objective To investigate the treatment of intracranial hemangiopericytoma（ HPC）and its prognostic factors. Methods The clinical data of 31 patients with intracranial HPC were reviewed,and the clinical characteristics and related factors affecting the survival period were analyzed and summarized. Results 31 patients with intracranial HPC underwent surgical resection.22 patients underwent complete resection and 9 total resection（ subtotal resection in 5,majority resection in 3,partial resection in 1）. WHO grade Ⅱ had 12 cases and WHO grade Ⅲ in 19.Thirteen patients underwent extracranial radiation and 10 underwent γ-knife treatment. Follow-up time was 12 ~ 96 months,with a median of 65 months. The 5-year relapse-free survival rate was53. 8% in all patients,with a median recurrence-free survival（ RFS） of 65 months. The median RFS was 76 months in the total resection group and 33 months in the non-total-cut group（ P 〈0. 01）.The median RFS was 76 months in patients receiving postoperative radiotherapy and 40 months in patients who underwent surgery alone（ P〈 0. 01）. The median RFS was 81 months in WHO gradeⅡ HPC patients and in WHO grade Ⅲ patients Median RFS was 40 months（ P 〈0. 01）.Conclusions Total resection of tumor and postoperative adjuvant radiotherapy can reduce the recurrence rate of HPC in situ and prolong the patient＇s RFS. This is an effective treatment for intracranial HPC.