儿童颅内胶质瘤临床特点回顾性分析

目的探讨儿童颅内胶质瘤的临床特点、治疗方法及预后。方法对2000~2013年收治的95例14颅内胶质瘤患儿的临床资料进行回顾性分析。结果肿瘤位于幕上50例、幕下45例。保守治疗20例,显微手术治疗55例,伽马刀治疗20例。55例手术患者中,肿瘤全切42例(76.4%),次全切13例(23.6%);术后病理学结果示胶质瘤WHO(2007)Ⅰ~Ⅱ级34例(61.8%),Ⅲ~Ⅳ级21例(38.2%)。48例患儿随访3~108个月,平均时间37.8月;保守治疗的2例患儿2年内均死亡;6例肿瘤全切患儿于术后3~15个月复发;其余40例随访期间未复发。结论儿童胶质瘤好发于近中线处,病理学类型以星形细胞瘤及髓母细胞瘤为主,治疗应以手术全切肿瘤为主,适当辅以化疗,预后相对较好。

Analysis of clinical characteristics of intracranial gliomas in children

Objective To explore the clinical characteristics, treatment and prognoses in children with intracranial gliomas. Methods The clinical data of 95 children with intracranial gliomas treated in our hospital from 2000 to 2013 were analyzed retrospectively, including the clinical manifestation, therapeutic method, prognoses and so on. Results Of 95 children with gliomas, 50 had supratentorial tumors, and 45 subtentorial ones. The conservative treatment was performed in 20 children, surgical treatment in 55 and gamma knife treatment in 20. Of 55 patients undergoing the operations, 42 received total excision of the tumors, and 13 partial excision. Of 55 tumors removed by surgery, 34 pathologically were WHO grade I and Ⅱ, and 21 grades Ⅲ and Ⅳ. Forty-eight children, of whom, 2 were conservatively treated, 36 surgically and 10 by gamma knife, were followed up from 3 to 108 months （mean, 37.8 months）. Two children treated by conservative method died. The tumors recurred in 6 children treated by surgery. No tumors recurred in the other 40 children including surgery and 10 by gamma knife. Conclusions The intracranial gliomas pathologically are mainly astrocytomas and medulloblastomas in children. The surgical removal of the tumors should be first selected in the children in whom, the prognoses are relatively good and postoperative long-term complications are less compared to the adults.