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儿童脊髓室管膜瘤术后放射治疗的疗效和预后分析
引用本文:宋丽楠,房彤,侯栋梁,孙保锦,杨慧,张楠,刘博.儿童脊髓室管膜瘤术后放射治疗的疗效和预后分析[J].中国肿瘤临床,2019,46(23):1212-1217.
作者姓名:宋丽楠  房彤  侯栋梁  孙保锦  杨慧  张楠  刘博
作者单位:首都医科大学附属北京世纪坛医院放疗科(北京市 100038)
摘    要:  目的  研究儿童脊髓室管膜瘤的临床特点、治疗转归和预后。  方法  回顾性分析2011年1月至2018年12月首都医科大学附属北京世纪坛医院收治的经病理证实的11例儿童脊髓室管膜瘤放射治疗患者的临床资料,观察疗效并结合文献进行分析。  结果  中位随访59个月,7例发生术后复发、播散,1例患儿死于疾病进展。放疗剂量为36.0~55.8 Gy,5次/周,1.7~1.8 Gy/次,平均剂量45.0 Gy。所有患儿放疗过程中未发生严重不良反应。3、5、8年无进展生存率(progression free survival,PFS)分别为42.4%、28.3%、28.3%。3、5、8年总生存率(overall survival,OS)分别为100%、87.5%、87.5%。  结论  手术切除程度是影响儿童脊髓室管膜瘤预后最重要的因素,对于肿瘤残存或间变性室管瘤患儿,术后放射治疗能有效提高局部控制率。 

关 键 词:脊髓    室管膜瘤    手术    放射治疗    预后
收稿时间:2019-11-01

Prognostic factors for postoperative pediatric spinal ependymomas after radiotherapy
Affiliation:Department of Radiotherapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
Abstract:  Objective  To evaluate prognostic factors and treatment results of patients with pediatric spinal ependymomas after radiotherapy.  Methods  This retrospective study included 11 pediatric spinal ependymoma patients who underwent a combination of surgical resection and radiotherapy at Beijing Shijitan Hospital, Capital Medical University from January 2011 to December 2018. The curative effect was analyzed, and the literature was reviewed.  Results  At a median follow-up of 59 months, 7 patients had recurrence and dissemination and 1 patient died of disease progression. The radiotherapy dose was 36-55.8 Gy, with 1.7-1.8 Gy per fraction and an average dose of 45 Gy. No serious adverse reactions occurred during radiotherapy in all pediatric patients. The 3-year progression-free survival (PFS) and overall survival (OS) were 42.4% and 100%, respectively. The 5-year PFS and OS were 28.3% and 87.5%, respectively.  Conclusions  Surgery is the primary treatment method. However, adjuvant radiotherapy is highly recommended for subtotal resection and anaplastic ependymomas(EP) patients. 
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