Magnetic resonance scans should replace biopsies for the diagnosis of diffuse brain stem gliomas: a report from the Children's Cancer Group.
Magnetic resonance scans should replace biopsies for the diagnosis of diffuse brain stem gliomas: a report from the Children's Cancer Group.
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DOI：
10.1227/00006123-199312000-00010
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发表时间：
1993-12
期刊：
影响因子：
4.8
通讯作者：
A. L. Albright;R. Packer;R. Zimmerman;L. Rorke;J. Boyett;G. Hammond
中科院分区：
文献类型：
--
作者：
A. L. Albright;R. Packer;R. Zimmerman;L. Rorke;J. Boyett;G. Hammond
儿童癌症小组方案 CCG-9882 旨在确定超分割放射治疗儿童和年轻人脑干胶质瘤的有效性。该研究于 1988 年 9 月 21 日开始招募患者，并于 1991 年 6 月 30 日结束。研究中的前 54 名儿童每天接受两次 100 cGy 的照射剂量，总剂量为 7200 cGy。接下来的 66 名儿童接受了类似的每日治疗方案，总计 7800 cGy。通过临床和放射学标准诊断肿瘤。是否需要手术的决定由主治神经外科医生自行决定；组织诊断并没有改变弥漫性浸润性肿瘤患者的治疗。我们回顾了神经放射学和神经外科报告以及参与研究的儿童的病理标本。根据磁共振 (MR) 成像标准，76% 的病例肿瘤累及大部分脑干；只有三名患者的肿瘤局限于中脑或髓质。 120 名患者中有 56 名（47%）接受了手术。 27 名儿童（23%）接受了脑脊液分流术； 11 例患者中仅进行了一次分流术，16 例患者中分流器与肿瘤手术同时插入。45 例（38%）患者进行了肿瘤手术； 24 人接受了立体定向活检，21 人接受了开颅手术。在 21 名接受开颅手术的患者中，11 名仅进行了活组织检查； 5例患者进行肿瘤部分切除术，5例患者进行次全切除术。（摘要截短250字）
Children's Cancer Group Protocol CCG-9882 was designed to determine the effectiveness of hyperfractionated radiation for the treatment of children and young adults with brain stem gliomas. The study opened for the accrual of patients on September 21, 1988, and was closed on June 30, 1991. The first 54 children in the study were treated with irradiation doses of 100 cGy given twice daily to a total dosage of 7200 cGy. The next 66 children were treated with a similar daily regimens to a total of 7800 cGy. Tumors were diagnosed by clinical and radiographic criteria. Decisions about the need for surgery were left to the discretion of the treating neurosurgeon; tissue diagnosis did not alter the therapy in patients with diffuse infiltrating tumors. We reviewed the neuroradiology and neurosurgery reports as well as the pathological specimens of children entered on the study. By magnetic resonance (MR) imaging criteria, tumors involved the majority of the brain stem in 76% of cases; only three patients had tumors localized to the midbrain or medulla. Operations were performed on 56 of 120 patients (47%). Cerebrospinal fluid shunts were inserted in 27 (23%) of the children; insertion of a shunt was the only operation in 11, and a shunt was inserted in conjunction with a tumor operation in 16. Tumor operations were performed in 45 (38%) of the patients; 24 had stereotactic biopsies, and 21 had craniotomies. Of the 21 patients who had craniotomies, only biopsies were performed in 11; partial tumor resections were performed in 5 patients and subtotal resection in 5.(ABSTRACT TRUNCATED AT 250 WORDS)