岩斜区脑膜瘤治疗策略的探讨

目的 探讨岩斜区脑膜瘤治疗策略的选择.方法 回顾性分析自1999年至2006年我们对44例岩斜区腩膜瘤患者进行的于术治疗,比较小同治疗策略对患者术后神绛功能、生存质量的影响及肿瘤复发或进展的情况.结果 根治性切除(GTR)16例,次全切除(NTR)20例,人部分切除(STR)8例.非根治性切除的患者术后放射外科治疗.术后1-2周评估神经功能,18例出现新的神经功能障碍或原有神经功能障碍加重,22例无改变,4例改善.术后1年GOS评分,GOS≥4分36例,GOS<4分8例.平均随访3年,肿瘤复发4例.结论 盲目追求岩斜区脑膜瘤GTR可能导致较高的神经功能损伤发病率,并可能影响患者的术后生存质量.NTR结合术后辅助放射治疗是较理想的岩斜区脑膜瘤治疗策略.

Discussion of the therapy strategy of meningiomas arising from petroclival region

Objective To define the optimal therapy of petroclival meningiomas. Method This retrospective analysis represented our experience with 44 petroclival meningiomas between 1999 and 2006. We compared their neurological deficits, living quality and tumor recurrence. Results Gross total resection (GTR) was achieved in 16 patients, near gross total resection(NTR) was achieved in 20 patients, and 8 achieved subtotal resection (STR). Postoperative radiation was administered to patients who had residual tumors. According to the postoperative evaluation of neurological function in 1-2 weeks, 18 patients experieneed new postoperative cranial nerve deficits, 22 remained the same, while 4 encountered slightly improvement. GOS was used to record the quality of life in survivors in 1-year-follow up, 36 of 44 were GOS ≥4,8 of 44 were GOS <4. And 4 tumor recurrences were observed after 3 years. Conclusions Blind pursuing GTR of tumors may significantly lead to a higher morbidity of postoperative cranial nerve deficits and depression of quality of life in survivors. NTR combined with postoperative radiotherapy may be a better strategy of petroclival meningiomas.