髓母细胞瘤的放疗：附17例分析

髓母细胞瘤恶性程度高,术后极易复发,但对射线敏感,我科1962～1984年收治17例髓母细胞瘤术后病例,经全中枢神经系统照射,即:全脑照射DT25～30Gy,后颅凹40～50Gy。全脊髓预防DT30Gy,结果6/17存活5年以上。本瘤常发于小脑蚓部侵犯第四脑室而引起脑脊液循环障碍。为避免在放疗中发生颅压增高,放疗前应先行手术,尽量切除肿瘤。由于瘤细胞易随脑脊液播散,因此应行全中枢神经系统照射。

Analysis of Radiotherapy in 17 Cases of Medulloblastoma

Medulloblastoma is the commonest tumor of the CNS in childhood. It has been reported that mere surgery failed to cure the patient and postoperative recurrence high. Being sensitive, radiotherapy can be a major countermeasure against this tumor. Medulloblastoma is a highly malignant tumor and usually develops in the vermis of cerebellum. It often invades and compresses the fourth ventricle leading to cerebrospinal fluid obstruction. Therefore, whole or partial tumor resection should be done before radiotherapy in order to prevent intracranial hypertension during radiotherapy. Since the tumor spreads by way of cerebrospinal fluid, total CNS irradiation is recommended. It is suggested that the whole brain should be given a radiation dose of 30 Gy, the posterior fossa 50 Gy and 30 Gy to the entire spinal cord. Between 1964 and 1984, a total of 17 cases treated according to the above-mentioned regime, 6 survived 5 or more years.