论文部分内容阅读
目的探讨髓母细胞瘤对放疗和化疗的敏感性及提高髓母细胞瘤治愈的可能性。方法回顾性分析了1987年2月～1997年2月我院用放射治疗和化疗的方法治疗了61例病例，儿童50例，中位年龄4．5岁（1～12岁），其中男性30例，女性20例。成人11例，中位年龄19岁（13～36岁），男性4例，女性7例。完全切除肿瘤有8例，部分切除肿瘤有3例。所有病人都采用全颅全脊髓分野照射。全依照射30～35Gy，后颅窝局部增量20～25Gy。成人每次照射剂量为1．8～2Gy，儿童每次照射剂量为1．6～1．8Gy。儿童病人都采用联合用药，成人病人主要应用VM26＋CDDP＋CCNU。结果儿童髓母细胞瘤病人放疗结束时CT片检查均发现肿瘤有明显退缩约50％，但无一例完全退缩。经过化疗后CT片复查发现肿瘤退缩不明显，生存期为3个月～7年，中位生存期为3年。成人髓母细胞瘤放疗后肿病退缩没有像儿童髓母细胞瘤那么明显，几乎没有改变。放疗后CT片有肿瘤存在的3例病人平均生存期为1年。CT片无肿瘤的8例病人均存活5年以上。结论髓母细胞瘤对放射线仅有部分敏感性。有一部分髓母细胞瘤细胞对放射线具有抵抗性。提高肿瘤手术切除率是提高病人生存率的重要因素。
Objective To investigate the sensitivity of medulloblastoma to radiotherapy and chemotherapy and to improve the possibility of medulloblastoma cure. Methods A retrospective analysis of the treatment of 61 cases with radiotherapy and chemotherapy in our hospital from February 1987 to February 1997 was performed in 50 children. The median age was 4.5 years (range from 1 to 12 years), including male 30. Cases, 20 women. There were 11 adults, with a median age of 19 years (13 to 36 years), 4 males and 7 females. Eight cases were completely resected and three cases were partially resected. All patients were irradiated with whole cranial and spinal cords. All in accordance with the injection of 30 ~ 35Gy, local increase in the posterior fossa 20 ~ 25Gy. Each adult dose is 1.8-2 Gy, and each dose is 1.6-1.8 Gy. All children are treated with a combination of drugs. Adults mainly use VM26+CDDP+CCNU. Results At the end of radiotherapy in children with medulloblastoma, CT examination revealed that the tumor had regressed by about 50%, but none of the patients had completely retreated. After chemotherapy, the CT scan revealed that tumor shrinkage was not obvious. The survival period was 3 months to 7 years, and the median survival period was 3 years. The retreat of edema of adult medulloblastoma after radiotherapy is not as obvious as that of medulloblastoma in children, and it is almost unchanged. The average survival time of 3 patients with tumors in the CT film after radiotherapy was 1 year. Eight patients with CT tumor-free all survived for more than 5 years. Conclusions Medulloblastoma is only partially sensitive to radiation. Some medulloblastoma cells are resistant to radiation. Raising tumor resection rate is an important factor in improving patient survival.