Hulshof M C, Menten J, Dito J J, Dreissen J J, van den Bergh R, González González D
Department of Radiotherapy, University of Amsterdam, The Netherlands.
Radiother Oncol. 1993 Dec;29(3):294-300. doi: 10.1016/0167-8140(93)90147-z.
During the period 1970-1990, 50 patients with primary intraspinal gliomas were treated with either surgery alone or combined surgery and postoperative irradiation. Thirty-four patients had an ependymoma. In this group, 17 patients had a macroscopically total tumor resection; 14 of these patients did not receive further additional treatment. The other 17 patients underwent a partial resection or biopsy; 11 of these patients received postoperative radiation therapy. There were 13 patients with astrocytoma and none of these tumors was radically resected. Twelve patients with astrocytoma received postoperative radiation therapy. Average total dose was 49 Gy for both histological types. The 10-year survival rate in the whole group of patients with ependymomas was 91%. Patients with ependymoma treated with partial tumor resection followed by radiotherapy had a similar survival rate as patients with total resected tumors without postoperative irradiation. The local recurrence rate of ependymomas was 25%, without differences between both treatment modalities. There were 3 major complications due to surgery and no late complications related to radiotherapy. The 10-year survival rate in the group of patients with astrocytoma was 43% and tumor progression was the most important cause of death. Three patients had a spongioblastoma and were treated with radiotherapy following biopsy or partial resection. These patients are alive 6, 11 and 15 years after treatment without evidence of disease. On the basis of our retrospective data and those in the literature we would recommend postoperative radiation therapy in all the intraspinal gliomas where total tumor resection is not possible. The recommended total dose is 50 Gy in 5-6 weeks.
在1970年至1990年期间，50例原发性脊髓胶质瘤患者接受了单纯手术或手术联合术后放疗。34例为室管膜瘤。在该组中，17例患者实现了肿瘤肉眼全切；其中14例患者未接受进一步的额外治疗。另外17例患者接受了部分切除或活检；其中11例患者接受了术后放疗。有13例星形细胞瘤患者，无一例肿瘤被根治性切除。12例星形细胞瘤患者接受了术后放疗。两种组织学类型的平均总剂量均为49 Gy。室管膜瘤患者全组的10年生存率为91%。接受部分肿瘤切除后放疗的室管膜瘤患者与未接受术后放疗的肿瘤全切患者生存率相似。室管膜瘤的局部复发率为25%，两种治疗方式之间无差异。手术导致3例严重并发症，未出现与放疗相关的晚期并发症。星形细胞瘤患者组的10年生存率为43%，肿瘤进展是最重要的死亡原因。3例为成胶质细胞瘤患者，在活检或部分切除后接受了放疗。这些患者在治疗后6年、11年和15年仍存活，无疾病证据。根据我们的回顾性数据及文献中的数据，我们建议对于所有无法实现肿瘤全切的脊髓胶质瘤患者均进行术后放疗。推荐的总剂量为50 Gy，在5至6周内完成。
