Clover L L, Hazuka M B, Kinzie J J
Division of Radiation Oncology, University of Colorado Health Sciences Center, Denver.
Am J Clin Oncol. 1993 Aug;16(4):350-3. doi: 10.1097/00000421-199308000-00016.
Between 1971 and 1990, 11 patients with primary spinal cord ependymomas were treated with surgery and postoperative irradiation or surgery alone at the University of Colorado Health Sciences Center. Of the 11 patients, 6 (54%) were subclassified with myxopapillary ependymomas that were located in the lumbosacral region of the spinal cord: 2 patients underwent complete resections, 8 had subtotal resections, and 1 had a biopsy only; 8 patients received postoperative irradiation (range: 4,500-5,482 cGy) with 7 of 8 patients treated to involved spinal fields. With a mean follow-up of 7.4 years, 3 patients (27%) have developed recurrent disease, 2 in the combined treatment group, and 1 in the surgery alone group. The 5- and 10-year actuarial survival rates were 100% and 80%, respectively. Eight of nine patients (89%) demonstrated clinical improvement after postoperative irradiation which suggests that the irradiation may have contributed to the improvement. The present study supports the long-term survival of patients with spinal cord ependymomas. Results from this series and a review of the literature indicate that complete surgical resection is only possible in about one-quarter of cases. Local spinal irradiation should continue to be utilized when surgery is incomplete.
1971年至1990年间，科罗拉多大学健康科学中心对11例原发性脊髓室管膜瘤患者进行了手术及术后放疗或单纯手术治疗。11例患者中，6例（54%）被分类为黏液乳头型室管膜瘤，位于脊髓腰骶部：2例行全切术，8例行次全切除术，1例仅行活检；8例患者接受术后放疗（范围：4500 - 5482 cGy），其中8例中的7例接受了累及脊髓野的治疗。平均随访7.4年，3例患者（27%）出现疾病复发，联合治疗组2例，单纯手术组1例。5年和10年实际生存率分别为100%和80%。9例患者中有8例（89%）术后放疗后临床症状改善，这表明放疗可能有助于改善病情。本研究支持脊髓室管膜瘤患者的长期生存。本系列研究结果及文献综述表明，约四分之一的病例能够实现完全手术切除。手术不完全时应继续采用局部脊髓放疗。
