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胶质母细胞瘤患者切除及辅助放化疗后发生的脑积水

Hydrocephalus after resection and adjuvant radiochemotherapy in patients with glioblastoma.

作者信息

Fischer Claudia M, Neidert Marian C, Péus Dominik, Ulrich Nils H, Regli Luca, Krayenbühl Niklaus, Woernle Christoph M

机构信息

Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.

Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.

出版信息

Clin Neurol Neurosurg. 2014 May;120:27-31. doi: 10.1016/j.clineuro.2014.02.012. Epub 2014 Feb 25.

Abstract

OBJECTIVE

Glioblastomas are the most common primary malignant brain tumors in adults with a poor prognosis. The current study sought to identify risk factors in glioblastoma patients that are closely associated with communicating hydrocephalus.

METHODS

We retrospectively analyzed data from 151 patients who were diagnosed with a glioblastoma between 2007 and 2011 and underwent complete surgical resection closely followed by adjuvant radiochemotherapy.

RESULTS

We observed a significant tendency toward communicating hydrocephalus in cases of ventricular opening during surgical tumor resection (Fisher's exact test p<0.001) and a noticeable, although not statistically significant, correlation between the onset of communicating hydrocephalus and evidence of leptomeningeal tumor dissemination (Fisher's exact test p=0.067). Additionally, there was a trend toward frontal tumor location and a larger tumor volume in patients with communicating hydrocephalus. The majority of patients suffering from communicating hydrocephalus received a cerebrospinal fluid (CSF) shunt implantation after radiation therapy (63.6%, Fisher's exact test p=0.000).

CONCLUSION

We identified the following risk factors associated with the onset of communicating hydrocephalus in glioblastoma patients: ventricular opening during tumor resection and leptomeningeal tumor dissemination. Shunt implantation seems to be safe and effective in these patients.

摘要

目的

胶质母细胞瘤是成人中最常见的原发性恶性脑肿瘤,预后较差。本研究旨在确定胶质母细胞瘤患者中与交通性脑积水密切相关的危险因素。

方法

我们回顾性分析了2007年至2011年间诊断为胶质母细胞瘤并接受了完整手术切除且随后紧密进行辅助放化疗的151例患者的数据。

结果

我们观察到在手术切除肿瘤期间脑室开放的病例中出现交通性脑积水有显著趋势(Fisher精确检验p<0.001),并且交通性脑积水的发生与软脑膜肿瘤播散证据之间存在明显的相关性,尽管无统计学意义(Fisher精确检验p = 0.067)。此外,交通性脑积水患者有肿瘤位于额叶和肿瘤体积较大的趋势。大多数患有交通性脑积水的患者在放疗后接受了脑脊液(CSF)分流植入术(63.6%,Fisher精确检验p = 0.000)。

结论

我们确定了胶质母细胞瘤患者中与交通性脑积水发生相关的以下危险因素:肿瘤切除期间脑室开放和软脑膜肿瘤播散。分流植入术在这些患者中似乎是安全有效的。

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