儿童颅内室管膜瘤术后放射治疗16例临床分析

A clinical analysis of 16 cases of postoperative radiotherapy of pediatric intracranial ependymomas

目的 观察儿童颅内室管膜瘤术后放射治疗的疗效。方法 1991年 1月～ 1998年 2月 ,16例儿童颅内室管膜瘤接受术后放疗。结果 本组总的 1、3、5年生存率分别为 10 0 .0 %、72 .9%、5 4 .7%。低分级室管膜瘤、肿瘤全部切除和照射剂量 >4 0Gy的 5年生存率分别为 6 2 .2 %、6 4 .3%、6 4 .3% ,分别高于高分级室管膜瘤、肿瘤部分切除和照射剂量 <4 0Gy的 4 7.6 %、4 4 .4 %、0。本组死亡 6例 ,其中 3例死于局部复发 ,占死亡患儿的 5 0 .0 % (3/ 6 ) ,2例死于局部残留病灶进展。结论 室管膜瘤的术后放疗可明显提高患儿的生存率。病理类型、手术切除范围和照射剂量是影响预后的重要因素。局部复发或局部残留病灶进展是治疗失败的主要原因。

Objective To observe the efficacy of postoperative radiotherapy in the pediatric intracranial ependymomas.Methods Between January. 1991 and Feb. 1998,16 children with histologicaly proved ependymoma received postoperative radiotherapy. Their clinical course was followed up. Results The over all survival rates of 1yr. 3yr. and 5yr. were 100.0%,72.9% and 54.7%, respectively.The 5yr. survival rates of low grade, complete resection and radiation dose over 40Gy. were 62.2%, 64.3% and 64.35% respectively, while those of high grade, imcomplete resection and radiation dose less than 40Gy. Were 47.6%, 44.4% and 0% respective. 6 patients died, of which 3 died of local reccurrence, 2 died of progression of local lesion, and 1 died of unconformed reason.Conclusion Postoperative radiotherapy can prolong the survival of children with ependymoma. The tumor grade, the extent of resection and the dose of radiation were important factors of prognosis. Local reccurrence and progression of local lesion were the main cause of treatment failure.