摘要
目的分析复发性岩斜区脑膜瘤(PCM)的预后及相关因素。方法回顾性分析39例复发性PCM病人的临床资料。手术治疗23例(手术组),伽玛刀(gamma knife surgery,GKS)治疗2例(GKS组),保守治疗14例(观察组)。手术组和GKS组统称为治疗组。结果手术组全切8例,近全切8例,部分切除6例,死亡1例。平均随访(70.4±63.3)个月,再次复发7例,死亡22例。全切、近全切及部分切除的无二次复发生存率(second progression/recurrence-free survival,2nd-PFS)分别为88%、67%、40%,其整体生存率(overall survival,OS)分别为88%、63%、33%。治疗组生存时间显著高于观察组(P<0.05)。全切为预后独立因素。治疗组OS显著优于观察组(P<0.05)。结论复发性PCM应积极治疗,保守观察可致不良预后。在保留神经功能的前提下,应尽可能全切肿瘤。
Objective To analyze the prognosis and its related factors of recurrent petroclival meningiomas（PCM）. Methods Clinical data of 39 recurrent PCM patients were analyzed retrospectively, who received resection as surgery group（ n = 23）, gamma knife surgery as GKS group（n = 2） and no treatment as observation group（n = 14）. The surgery and GKS groups were referred as treatment group. Results Gross total resection was achieved in 8 patients, subtotal resection in 8, partial resection in 6 and 1 died in surgery group. During a mean follow-up period of 70.4 ±63.3 months, 7 patients experienced a 2ndrecurrence and 22 patients died. The percentage of the 2ndprogression/recurrence-free survival of gross total resection, subtotal resection, and partial resection were 88%,67% and 40% respectively. The overall survival of gross total resection, subtotal resection, and partial resection were 88%, 63% and33% respectively. Compared with observation group, survival duration was longer and overall survival rate was higher in treatment group（P〈0.05）. The gross total resection was the only independent prognostic factor. Conclusions Active treatment should be performed on patients with recurrent PCM. Conservative observation can result in poor outcome. Gross total resection as a preferential therapeutic strategy should be pursued as far as possible on the condition of minimal functional impairment.
出处
《中国微侵袭神经外科杂志》
CAS
2015年第5期196-199,共4页
Chinese Journal of Minimally Invasive Neurosurgery
