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題 名 | Pediatric Intracranial Germinoma Treated with Chemotherapy Alone=以化學療法治療兒童顱內胚芽瘤之預後:臺北榮民總醫院的經驗 |
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作 者 | 房國堂; 張開屏; 黃棣棟; 郭萬祐; 何明德; 胡文龍; | 書刊名 | 中華醫學雜誌 |
卷 期 | 62:12 1999.12[民88.12] |
頁 次 | 頁859-866 |
分類號 | 417.6271 |
關鍵詞 | 化學療法; 生殖細胞瘤; 顱內; 顱內胚芽瘤; Chemotherapy; Germ cell tumor; Intracranial; Intracranial germinoma; |
語 文 | 英文(English) |
中文摘要 | 背景:目前,放射線治療已公認為治療兒童顱內胚芽瘤的標準療法,但此療法會對中樞神經這成明顯的延遲性傷害,而化學療法巳被證實對治療此種疾病有效。在過去10年,我們以化學療法治療了11位罹患顱內胚芽瘤的病童。本研究的目的是評估以化學療法治療兒童顱內胚芽瘤的預後。 方法:我們共收集了11位初次診斷為顱內胚芽瘤及未普使用過放射線治療的病童,以組合性化學療法作治療,並分析病童對化學療法的反應、復發及預後情況。 結果:這些病童之後續追蹤治療期為17-102個月。我們發現11位病童對化學療法皆完全反應。其中5位顱內胚芽瘤位於中線位置的病童,在僅接受化學療法後便得到完全緩解且未再復發;而另外6位有復發情形,但在接受放射線治療、化學療法或手術治療後,也能再度完全緩解。復發時間約為9.24個月,平均16.8個月。 結論:化學療法對初次診斷的兒童顱內胚芽瘤的確有效。雖然約有半數病例復發,但全部皆能存活。值得注意的是,其中有5位病童完全避免了放射線治療及其後遺症。 |
英文摘要 | Background: Pediatric intracranial germinoma treated with radiotherapy is considered a standard treatment, but may cause significant delayed damage to the central nervous system. Chemotherapy has been shown to be effective for the treatment of an intracranial germinoma. In the past 10 years, we treated 1 1 cases of primary intracranial germinoma with chemotherapy alone. The purpose of this retrospective study is to review the clinical outcome of these patients. Methods: Eleven children with newly diagnosed, previously untreated primary intracranial germinomas were treated with six courses of chemotherapy (vinblastine bleomycin, cisplatin and etoposide, VBPE). The response to chemotherapy, relapses and outcomes are reviewed and evaluated. Results: All 11 assessable children achieved a complete response and are alive, with a median follow-up of 61 months. Five patients with tumors located in the midline position of the brain, including pineal, sellar, suprasellar and hypothalamic areas, had no relapse. Six patients had relapses, and all of them achieved a second complete remission after salvage focal radiotherapy. The time of onset of relapse was from nine to 24 months after chemotherapy, with an average of 16.8 months. Conclusions: VBPE chemotherapy was effective for treating newly diagnosed intracranial germinomas. Although a high rate of relapse (6/1 1) was observed, all of these patients survived with first or second complete remissions. It was beneficial for five children that focal radiation was eliminated and delayed post-irradiation neurologic sequelae were avoided. |
本系統中英文摘要資訊取自各篇刊載內容。