颅内生殖细胞瘤综合治疗的初步效果

①目的 探讨颅内生殖细胞瘤的综合治疗方法。②方法 回顾分析18例颅内生殖细胞瘤采用单纯全中枢照射、单纯全脑照射及低剂量全脑照射联合化疗3种治疗方法的疗效及并发症。③结果 放化疗联合组与全中枢照射组4年总生存率及无复发生存率比较差异均无显著性（P＝1．000，0．416）；儿童生长延迟及智力发育障碍发生率以放化疗联合组为低（P＝0．0009，0．001）；单纯全脑照射组复发率高于全中枢照射组及放化疗联合组，差异有极显著性（P＝0．003）。④结论 全脑照射联合化疗的综合治疗方法初步效果满意，且并发症低，尤其适用于儿童病人。对于播散性病变或多灶性病变病人不宜给予单纯全脑照射。

PRELIMINARY RESULTS OF COMBINED THERAPY FOR INTRACRANIAL GERMINOMA

Objective To investigate the combined therapy for intracranial germinoma. Methods The therapeutic results of 18 cases with intracranial germinoma were analyzed retrospectively. The effects and complications were compared among three groups: craniospinal irradiation, whole brain irradiation and whole brain irradiation plus chemotherapy. Results No differences of 4 year survival and disease free survival were observed between the combined therapy group, i.e. irradiation plus chemotherapy, and the craniospinal irradiation group ( P =1.0, 0.416 ). The combined therapy group had a lower morbidity of growth retardation and mental deficiency for children ( P =0.000 9 , 0.001 ).The whole brain irradiation group had the highest recurrence( P =0.003). Conclusion The combined therapy of whole brain, lower dose irradiation plus chemotherapy achieved satisfactory effects with less complications. It is unwise to treat the patients with disseminated or multiple foci by whole brain irradiation alone. The combined therapy of irradiation plus systemic chemotherapy is a treatment of choice ,especially for children.