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目的探讨小儿恶性脑肿瘤的年龄分布特点、肿瘤部位分布、肿瘤性质排序、手术切除程度、病理特点及综合治疗效果。方法回顾性分析经手术治疗的61例恶性脑肿瘤患儿的临床资料,包括恶性脑肿瘤的年龄分布及诊断,依据肿瘤部位不同选择相应的手术入路,局部加全脑照射放疗、三维适形放疗、γ-刀及X-刀等放疗措施。卡氮介(BCNU)、替尼泊苷(VM-26)、替莫唑胺进行化疗方案。结果恶性肿瘤61例。男37例,女24例;平均年龄11.3岁。其中幕上24例,幕下37例。肿瘤行显微镜下全切除、次全切除45例,大部分切除10例,部分切除6例。术后放射治疗39例,占63.9%。化疗29例,占47.5%。随访49例,其中存活27例,死亡22例。结论小儿恶性脑肿瘤的治疗以手术切除为主,根据各个病例的特殊性,制定不同的手术切除方案,术后依据复查头颅CT或MRI结果选择不同的放疗方法,但应有别于成人脑肿瘤。选择适合的病例进行化疗,对于延长小儿的生存期是有效的。
Objective To investigate the age distribution characteristics of pediatric malignant brain tumors, the distribution of tumor sites, the nature of the tumor, surgical resection, pathological features and comprehensive treatment. Methods The clinical data of 61 children with malignant brain tumor undergoing surgery were retrospectively analyzed. The age, distribution and diagnosis of malignant brain tumor were retrospectively analyzed. The corresponding surgical approaches were selected according to the location of tumor. Local plus whole brain irradiation and radiotherapy, three-dimensional conformal Radiotherapy, γ-knife and X-knife and other radiotherapy measures. Carnitine mediated (BCNU), teniposide (VM-26), temozolomide chemotherapy. 61 cases of malignant tumors. 37 males and 24 females with an average age of 11.3 years. Among them, 24 were on the screen and 37 were under the screen. Tumor underwent total microsurgical resection, subtotal resection in 45 cases, the majority of resection in 10 cases, partial resection in 6 cases. Postoperative radiotherapy in 39 cases, accounting for 63.9%. 29 cases of chemotherapy, accounting for 47.5%. 49 cases were followed up, of which 27 survived and 22 died. Conclusion The surgical treatment of malignant brain tumors in children is mainly based on the particularity of each case, and different surgical resections are made. Different radiotherapy methods are selected according to the results of skull CT or MRI after operation, but different from that of adult brain tumors . Select the appropriate case for chemotherapy, to extend the survival of children is effective.