Rodriguez L A, Edwards M S, Levin V A
Department of Neurological Surgery, School of Medicine, University of California, San Francisco.
Neurosurgery. 1990 Feb;26(2):242-6; discussion 246-7. doi: 10.1097/00006123-199002000-00010.
The cases of 33 children with hypothalamic-chiasmatic gliomas are reviewed. Radiation therapy produced clinical or radiographic improvement in 11 (46%) of 24 patients. Progression was documented in 18 patients (54%). Overall, the median time to tumor progression was 60 months; it was 70 months in patients who received radiation therapy and 30 months in those who did not (P less than 0.05). Chemotherapy, either given initially or at the time of progression, caused the tumor to respond or to stabilize in 10 patients. Partial resection of the tumor led to improvement in 3 of 12 patients, obviating the need for a shunt in 2 of them; there were no deaths and postoperative morbidity was transient and minimal (diabetes insipidus, intraventricular hemorrhage, and left hemiparesis in one patient each). The 5- and 10-year survival probabilities were 93 and 74%, respectively. Patients with neurofibromatosis had a better prognosis.
对33例下丘脑 - 视交叉胶质瘤患儿的病例进行了回顾。24例患者中，11例（46%）经放射治疗后临床症状或影像学表现得到改善。18例患者（54%）有病情进展记录。总体而言，肿瘤进展的中位时间为60个月；接受放射治疗的患者为70个月，未接受放射治疗的患者为30个月（P<0.05）。化疗无论是在初始阶段还是在病情进展时使用，10例患者的肿瘤出现反应或病情稳定。12例患者中3例行肿瘤部分切除术，其中2例无需分流；无死亡病例，术后并发症短暂且轻微（分别有1例患者出现尿崩症、脑室内出血和左侧偏瘫）。5年和10年生存率分别为93%和74%。患有神经纤维瘤病的患者预后较好。
