中枢神经系统复发性血管外膜细胞瘤临床特点分析

目的探讨中枢神经系统复发性血管外膜细胞瘤(HPC)的临床特点。方法回顾性分析46例复发性HPC病人的临床资料,均行手术全切除或次全切除肿瘤,其中辅助放疗29例,辅助伽玛刀治疗7例。采用统计学分析复发性HPC病人术后的生存期及生存期的影响因素。结果 46例病人术后随访3~164个月,平均生存期为(41.6±4.4)个月,术后1、2、3、4年生存率分别为80.4%、65.2%、59.2%和53.8%。所有复发性HPC病人中,复发1次30例,其平均生存期为(36.9±4.1)个月;复发2次及以上16例,其平均生存期为(39.7±7.0)个月。随访期间死亡18例,其平均生存期为(14.2±5.6)个月;存活28例,其平均KPS评分为(86.8±14.2)分。经统计学分析:复发性HPC病人的生存期与性别及肿瘤部位、大小、质地、病理分级之间无相关性(P0.05);复发1次与复发2次及以上病人的生存期间亦无显著差异(P0.05)。结论积极综合治疗复发2次及以上的HPC病人,预后仍可令人满意。

Analysis of clinical features of recurrent hemangiopericytoma in central nervous system

Objective To explore the clinical characteristics of recttrrent hemangiopericytoma （HPC） in central nervous system. Methods Clinical data of 46 patients with recurrent HPC were analyzed retrospectively. The total or subtotal tumor resection was performed in all the patients, and assisted with radiotherapy in 29 cases and gamma knife treatment in 7. The postoperative survival and factors related to survival of recurrent HPC were analyzed by statistical methods. Results Forty-six patients were followed up 3 to 164 months, and the mean survival time of 46 patients was 41.6±4.4 months, with 1-, 2-, 3-, and 4-year survival rates of 80.4%, 65.2%, 59.2%, and 53.8% respectively. Thirty patients suffered their first tumor recurrence, with the mean survival time of 36.9±4.1 months. Sixteen patients suffered a second or more tumor recurrence, with the mean survival time of 39.7±7.0 months. Eighteen patients died during the follow-up period, with the mean survival of 14.2±5.6 months. The mean KPS score was 86.8±14.2 for the 28 live patients. No significant correlation was shown between survival time of recurrent HPC and such factors as patient gender and tumor location, size, texture and pathological grade （P〉0.05）. There was also no significant difference between patients suffering once recurrence and twice or more recurrences in their mean survival time （P〉0.05）. Conclusions For HPC patients with twice or more recurrences, the prognosis is still satisfactory as long as comprehensive treatment is given actively.