摘要
目的 观察颅内生殖细胞瘤经过化疗并辅以中低剂量放疗后的疗效及对儿童生长发育的影响。方法 自 1 993年 1 2月至 2 0 0 1年 1 2月共对 63例颅内生殖细胞瘤的儿童进行静脉化疗并辅以中低剂量放疗 ,随访到 34例 ,其中肿瘤位于松果体区 2 0例 ,松果体区并鞍区 6例 ,鞍区 4例 ,松果体区并脑室内 3例 ,底节区 1例。使用药物为长春新碱、甲氨蝶呤、平阳霉素及顺铂。用药后每周化验 2次血常规 ,1次血生化 ,以观察周围血象变化及心、肝、肾功能情况 ,并进行针对性治疗。 4周后如血常规及血生化的各项指标均正常 ,再行第二疗程化疗。 2个疗程结束后 1个月 ,在肿瘤病灶局部补充中低剂量 (2 5～ 35Gy)的放疗。每个疗程间进行CT或MRI检查 ,观察肿瘤消退的情况。结果 34例患者随访最短 1年 ,最长 7年。 1例为手术加全剂量放疗后 2年肿瘤复发 ,此次化疗进行 2个疗程 ,但化疗后未再补充放疗 ,4年后肿瘤复发 ,家属放弃治疗 ,患者死亡。 1例化、放疗后 5年肿瘤复发 ,再行 2个疗程化疗 ,疗效较首次治疗差。其余 32例 (94% )化、放疗后 1～ 7年 ,复查MRI显示肿瘤无复发 ,患者生存质量良好 ,儿童生长发育及智力均未受影响。
Objective To study the clinical effects of chemotherapy and radiotherapy of children intracranial germinoma. Methods From December 1993 to December 2001, we counducted chemotherapy and radiotherapy to 63 children with intracranial germinomas. 34 patients have been followed up. Out of them, 20 cases have tumors in the pineal region, 6 cases have tumors in the pineal and suprasellar regions, 4 cases have tumors in the suprasellar region, 3 cases have tumors in the pineal region and cerebral ventricle, 1 case has tumor in the basal ganglia. The durgs we used are VCR, MTX, Bleomycin and Cisplatin (DDP). Four days are considered as one course of treatment. A repeat course was taken after 4 weeks. CT and/or MRI were repeated 1 month after the second course. Local radiotherapy was taken with low or middle dosage (25 35Gy) 1 2 month after chemotherapy. Results 34 children have been followed up from 1 to 7 years. One child died within 4 years after chemotherapy. The other child has tumor relapsing 5 years after chemotherapy. Who was given chemotherapy again for two courses and got a satisfied outcome. 32 patients (94%) survived and recovered well. Conclusions Combination of chemotherapy and local radiotherapy with low or middle dosage is the best choice for treatment of children intracranial germinomas.
出处
《中华神经外科杂志》
CSCD
北大核心
2003年第1期3-6,共4页
Chinese Journal of Neurosurgery
