Hirsch J F, Renier D, Pierre-Kahn A, Benveniste L, George B
Neurochirurgie. 1978;24(6):391-7.
The authors report on a series of 57 medulloblastomas operated upon in children from 1964 ot 1976. Among these children, 44 completed the treatment with radiotherapy of the whole central nervous system. The post-operative mortality rate in 10,5%. Postoperative death occurred mainly in infants or when the tumor involved the brain stem. The five years survival rate is 46,6% in the whole series. It raises up to 50% in the series of the patients who completed the treatment with radiotherapy. The study shows that the life of survivals is frequently impaired by mental or behavioural disturbances. I.Q. varies from 70 to 90 in 66% of the children; it is below 70 in 20%. Behavioural disturbances are found in 91% of cases, wrong space orientation, speech or writing disabilities in 87%. In order to evaluate the responsibility of ray therapy in the development of these sequelae, the results have been compared to those of a series of cerebellar astrocytomas surgically removed, but not irradiated. The comparison shows that radiotherapy is at least partially responsible for the mental and behavioural disturbances.
作者报告了1964年至1976年期间对57例儿童髓母细胞瘤进行手术治疗的情况。在这些儿童中,44例完成了全中枢神经系统放射治疗。术后死亡率为10.5%。术后死亡主要发生在婴儿或肿瘤累及脑干的情况下。整个系列的五年生存率为46.6%。在完成放射治疗的患者系列中,这一比例上升至50%。研究表明,幸存者的生活常常受到精神或行为障碍的影响。66%的儿童智商在70至90之间;20%的儿童智商低于70。91%的病例存在行为障碍,87%的病例存在空间定向错误、言语或书写障碍。为了评估放射治疗在这些后遗症发生中的责任,将结果与一系列手术切除但未接受放射治疗的小脑星形细胞瘤的结果进行了比较。比较结果表明,放射治疗至少部分导致了精神和行为障碍。