脑肿瘤放疗后假性进展的诊断及治疗(附14例报告)

目的 探讨脑肿瘤放疗后假性进展的诊断及治疗方法 .方法 通过分析14例脑胶质瘤放疗后假性进展患者的临床资料,结合当今有关脑肿瘤假性进展的研究,对脑肿瘤假性进展的诊断和治疗进行分析总结.结果 本组病例中以放疗不当为脑肿瘤假性进展的主要原因,以头痛为首发症状,可伴有神经功能缺失,糖皮质激素治疗对11例患者有效,对于治疗效果不明显的3例患者,采用二次手术切除病灶,组织病理学检查证实为脑组织坏死.结论 脑肿瘤放疗后假性进展的诊断应综合分析患者的临床资料、PET和MRS检查的结果 ,治疗以糖皮质激素为主.

Diagnosis and treatment of pseudoprogression of brain tumor after radiotherapy

Objective To explore the diagnosis and treatment of pseudoprogression of brain tumor after radiotherapy. Methods The clinical materials of 14 patients with pseudoprogression of gliomas after radiotherapy were retrospectively analyzed, which were consecutively treated in our department from October 2004 to July 2009. Results The main cause of pseudoprogression was unsuitable radiotherapy. Headache was the first symptom and may be accompanied with neurologic deficits. Corticosteroid hormone was effective for the treatment of pseudoprogression in 11 patients. The other 3 patients received surgical treatment again after corticosteroid therapy being ineffective, and the histopathological results demonstrated that the tissue samples were necorsis. Conclusions Diagnosing pseudoprogression of brain tumor should comprehensively analyze the clinial materials of patients and results of PET imaging and MR spectroscopy. Corticosteroid hormone was the first choice for the treatment of pseudoprogresion.