儿童第四脑室室管膜瘤的综合治疗及预后

Combined treatment and prognosis of ependymoma in fourth ventricle of the brain of child

目的总结儿童第四脑室室管膜瘤的外科治疗经验,探讨其综合治疗的效果。方法全组44例,均采用显微外科手术切除第四脑室室管膜瘤,术后2～3周内28例实施全脑全脊髓加局部放疗;13例仅作局部放疗,其中5(5/13)例为伽玛刀治疗;其他3例未作放疗。结果全切肿瘤32例,次全切除12例,无手术死亡。术后恢复良好23例,轻残15例,重残6例。全切肿瘤组、次全切组,全脑全脊髓加局部放疗组、局部放疗组及未放疗组5年生存率分别为96.8%、8.3%、78.6%、69.2%和0.0%。结论手术治疗儿童第四脑室室管膜瘤能获得良好的效果,全切肿瘤及术后全神经轴加局部放疗能延长患者生存时间。

Objective To summarize experience of the combined treatme nt of ependymoma in fourth ventricle of the brain of child and to study improvem ent of effect of the operation plus radiotherapy.Methods The44cases with ep endymoma in fourth cerebral ventricle were treated with microneuro-surgical re section.Among the44cases,28were treated with total brain and spinal cord p lus local focus radiotherapy with in2to3weeks after operation;13only with l ocal focus radiotherapy,of which5with gamma knife;and other3cases were not done with radiotherapy.Results Total removal of tumors was done in32cases,su btotal removal in12cases,and no patient died from operation.After operation ,33patients had a good recovery,15had a light disability,and6needed ass istance.The5-year-survival rate is96.8%,8.3%,78.6%,69.2 %,0.0%in different group respectively.Conclusion Surgical treatment is obviously effective to ependymoma in fourth ventricle of the brain,and total r emoval of tumors combined with radiotherapy is aid to extend the patient 's sur vival time.