Tomita T, McLone D G, Das L, Brand W N
Division of Pediatric Neurosurgery, Children's Memorial Hospital, Chicago, Ill.
Pediatr Neurosci. 1988;14(6):277-85. doi: 10.1159/000120405.
A series of 22 infants and children with posterior fossa benign ependymomas treated surgically during the past 12 years is presented. All patients were operated on with posterior fossa craniotomy: visible total resection in 10, subtotal resection in 9, partial resection in 2 and biopsy only in 1. One patient (4.5%) died shortly after surgery. Only 5 patients had documented infiltration of the floor of the fourth ventricle. Postoperative radiotherapy was administered with variable radiation fields and doses. Two out of six patients who had total resection and postoperative radiation therapy did not show recurrence during at least 26 months follow-up period. However, patients with incomplete tumor resection almost invariably developed recurrence. An attempt should be made to remove posterior fossa ependymomas totally at the initial craniotomy. The risk periods for recurrence were between 1 and 2 years after subtotal resection and between 2 and 3 years after total resection. In our experience, gross recurrent tumors appear to be resistant to chemotherapy, and a combination of surgery and radiation therapy does not necessarily prevent recurrence. Newer agents or protocols of adjuvant chemotherapy are needed to explore.
本文报告了过去12年间接受手术治疗的22例患有后颅窝良性室管膜瘤的婴幼儿及儿童。所有患者均接受后颅窝开颅手术：10例实现肉眼下全切，9例次全切除，2例部分切除，仅1例活检。1例患者（4.5%）术后不久死亡。仅5例患者记录有第四脑室底浸润。术后放疗采用不同的照射野和剂量。6例接受全切及术后放疗的患者中有2例在至少26个月的随访期内未出现复发。然而，肿瘤切除不完全的患者几乎均出现复发。初次开颅手术时应尝试全切后颅窝室管膜瘤。次全切除术后1至2年以及全切术后2至3年为复发风险期。根据我们的经验，肉眼可见的复发肿瘤似乎对化疗耐药，手术与放疗联合并不一定能预防复发。需要探索更新的辅助化疗药物或方案。
