Duffau Hugues, Taillandier Luc, Capelle Laurent
Department of Neurosurgery, UMR-S678, Inserm/UPMC, Hôpital Salpêtrière, 75651, Paris, Cedex 13, France.
J Neurooncol. 2006 Nov;80(2):171-6. doi: 10.1007/s11060-006-9168-3. Epub 2006 Apr 28.
While surgery is proned in low-grade glioma (LGG), the invasion of functional areas frequently prevents a complete resection. We report the first case of a patient operated on for a left frontal LGG, diagnosed because of seizures, with partial resection due to an invasion of the controlateral hemisphere. Chemotherapy enabled a regression of this controlateral extension. Postchemotherapy surgery performed with intraoperative functional mapping then allowed a complete resection, without sequelae. The patient has a normal socio-professional life, with no seizure. No other treatment was given. There was no recurrence, with a follow-up of 2 years since the second surgery (3.5 years since the first symptom). We propose a new therapeutic strategy in unresectable LGG, with preoperative chemotherapy, to make a radical surgery possible in a second step, while preserving the quality of life.
虽然手术适用于低级别胶质瘤（LGG），但功能区的侵犯常常阻碍完全切除。我们报告了首例因癫痫发作而诊断为左侧额叶LGG并接受手术的患者，由于对侧半球侵犯而进行了部分切除。化疗使这种对侧扩展得以消退。化疗后手术结合术中功能定位随后实现了完全切除，且无后遗症。患者社会职业生活正常，无癫痫发作。未给予其他治疗。自第二次手术起随访2年（自首次出现症状起3.5年）无复发。我们提出一种针对不可切除LGG的新治疗策略，即术前化疗，以便在第二步实现根治性手术，同时保留生活质量。
