Sgouros S, Fineron P W, Hockley A D
Department of Neurosurgery, Queen Elizabeth Hospital, Birmingham, UK.
Childs Nerv Syst. 1995 Feb;11(2):89-96. doi: 10.1007/BF00303812.
Cerebellar astrocytoma of childhood has always been regarded as a benign tumour. Certain issues still attract debate, in particular the role of radiotherapy as an adjuvant to surgery, management of the cyst wall in cystic lesions and treatment of recurrent tumours. To provide some answers to these questions, the experience in Birmingham (United Kingdom) between the years 1959 and 1991 was reviewed. Ninety-seven patients aged 0-14 years had been treated and the histological material was reassessed independently. Detailed statistical and clinical analysis revealed that the main factor of negative prognostic value was the presence of brain stem involvement. In cystic tumours the surgical excision of the cyst wall did not offer significant advantage on survival. Similarly, postoperative radiotherapy did not improve survival, and there is a suggestion that it may actually predispose to malignant transformation. The implications on management are discussed.
儿童小脑星形细胞瘤一直被视为良性肿瘤。某些问题仍存在争议，特别是放疗作为手术辅助手段的作用、囊性病变中囊肿壁的处理以及复发性肿瘤的治疗。为了对这些问题提供一些答案，回顾了1959年至1991年期间英国伯明翰的经验。97例0至14岁的患者接受了治疗，并对组织学材料进行了独立重新评估。详细的统计和临床分析表明，预后不良的主要因素是脑干受累。在囊性肿瘤中，手术切除囊肿壁对生存率没有显著优势。同样，术后放疗也没有提高生存率，并且有迹象表明它实际上可能易引发恶性转化。文中讨论了其对治疗的影响。
