Bellani F F, Gasparini M, Lombardi F, Zucali R, Luccarelli G, Migliavacca F, Moise S, Nicola G
Cancer. 1984 Nov 1;54(9):1956-61. doi: 10.1002/1097-0142(19841101)54:9<1956::aid-cncr2820540928>3.0.co;2-j.
Actuarial progression-free survival rate at 5 years of a series of 34 patients with medulloblastoma treated by combined surgery, radiotherapy, and chemotherapy was 71%. No relapses were observed in 14 patients followed for more than 5 years. Treatment consisted of a short postoperative course of vincristine (VCR) and intrathecal (IT) methotrexate (MTX) followed by irradiation to the entire cranio spinal axis. Maintenance chemotherapy (CCNU, VCR, and IT MTX) was then continued to encompass 2 years from surgery. Failure occurred in nine patients: four had local recurrence, four dissemination within the central nervous system, and one widespread skeletal metastases. Poor prognostic factors such as presence of malignant cells in the cerebrospinal fluid, non-radical surgery, young age, and radiation doses less than 50 Gy to the tumor bed, did not adversely affect the outcome of patients in this series. Long-term sequelae from the treatment program could be observed in all patients, and in 58% they were severe enough to interfere with normal, active life.
一组34例接受手术、放疗和化疗联合治疗的髓母细胞瘤患者的5年精算无进展生存率为71%。在随访超过5年的14例患者中未观察到复发。治疗包括术后短期使用长春新碱（VCR）和鞘内注射甲氨蝶呤（MTX），随后对整个颅脊柱轴进行照射。然后继续进行维持化疗（洛莫司汀、VCR和鞘内MTX），从手术开始为期2年。9例患者出现失败：4例局部复发，4例中枢神经系统内播散，1例广泛骨转移。脑脊液中存在恶性细胞、手术不彻底、年龄小以及肿瘤床放射剂量小于50 Gy等不良预后因素，并未对该系列患者的预后产生不利影响。在所有患者中均可观察到治疗方案的长期后遗症，其中58%严重到足以干扰正常的积极生活。
