O'Sullivan C, Jenkin R D, Doherty M A, Hoffman H J, Greenberg M L
Division of Radiation Oncology, Toronto-Bayview Regional Cancer Centre, Sunnybrook Health Science Centre, Ontario, Canada.
J Neurosurg. 1994 Oct;81(4):507-12. doi: 10.3171/jns.1994.81.4.0507.
The authors report a series of 31 children under 17 years of age with primary spinal cord tumors who underwent radiation treatment following decompression laminectomy with or without tumor resection between 1959 and 1990. The tumors consisted of 15 astrocytomas, 11 ependymomas, one mixed glioma, one gangliolioma, and three of unknown histology. Ten- and 20-year survival rates and 10- and 20-year relapse-free survival rates for the 28 patients with known histology were 80% and 53%, and 73% and 67%, respectively. Eleven patients (35%) had no resection, 14 (45%) had a partial resection, and six (19%) had a grossly complete resection. Eight patients (26%) are dead: five due to recurrent tumor, two due to a second malignant tumor, and one due to intercurrent disease. primary tumor relapse or progression occurred in nine patients (29%), four of whom were salvaged. A second malignant tumor developed in four patients (13%), two of whom died. Local control of the tumor was finally achieved in 26 cases (84%), despite either grossly incomplete or no resection in 25 of these cases (81%). These statistics suggest that radiation treatment without resection may achieve long-term control in children with astrocytoma or ependymoma of the spinal cord.
作者报告了一系列31例17岁以下患有原发性脊髓肿瘤的儿童，他们在1959年至1990年间接受了减压椎板切除术后进行了放射治疗，部分患者还进行了肿瘤切除术。这些肿瘤包括15例星形细胞瘤、11例室管膜瘤、1例混合性胶质瘤、1例神经节胶质瘤以及3例组织学类型不明的肿瘤。28例组织学类型明确的患者的10年和20年生存率以及10年和20年无复发生存率分别为80%和53%，以及73%和67%。11例患者（35%）未进行切除，14例（45%）进行了部分切除，6例（19%）进行了大体完整切除。8例患者（26%）死亡：5例死于肿瘤复发，2例死于第二原发性恶性肿瘤，1例死于并发疾病。9例患者（29%）出现原发性肿瘤复发或进展，其中4例得到挽救。4例患者（13%）发生了第二原发性恶性肿瘤，其中2例死亡。尽管26例患者中有25例（81%）的肿瘤切除不彻底或未进行切除，但最终26例（84%）患者的肿瘤得到了局部控制。这些统计数据表明，对于脊髓星形细胞瘤或室管膜瘤患儿，不进行切除的放射治疗可能实现长期控制。
