28例基底节区生殖细胞瘤诊断性放疗的评价

目的分析丘脑及基底节区生殖细胞瘤的临床、影像学特点,诊断性放疗及小剂量局部放疗加静脉化疗的治疗效果.方法回顾性分析了28例局限于丘脑及基底节区经诊断性放疗证实的生殖细胞瘤的临床特点和疗效.患者肿瘤局部照射剂量为35～40Gy/3-4周.放疗后1个月行VMPP化疗两疗程,每间隔6个月复查MRI,随访时间1-3.5年.结果所有病例均无瘤生存,无复发,未见放射性损伤.但患者肿瘤对侧的肢体运动障碍无明显改善.结论丘脑及基底节区生殖细胞瘤有独特的影像学特点,通过诊断性放疗可以进一步确诊.

Clinical feature and treatment of germinoma in the basal ganglia and the thalamus regions: report of 28 cases

Objective To analyze the clinical feature of thalamus and basal ganglia originated germinoma and to evaluate the therapentic effect of diagnostic radiation in combination with intravenous chemotherapy. Methods The clinical feature and therapy effect were reviewed retrospectively in 28 cases of germinoma arising from the thalamus and the basal ganglia regions whose diagnosis was confirmed by the diagnostic radiation. The patients received the local therapy of 35-40 Gy total radiation in 3 - 4w, following 2 courses of VMPP (vincristine, methotrexate, pingyangmycin and cisplatin ) combination chemotherapy 1 month later, and had an MR examination at 6 months interval. The patients had a 1 - 3. 5y follow-up until now. Results Every case survived without tumor recurrence during follow-up and there was no evidence of radiotherapy induced necrosis among these patients. But no improvement was achieved in movement disorder of the patients after therapy. Conclusions Germinoma originating from thalamus and basal ganglia has specific imaging characteristic and can be further confirmed by diagnostic radiation.