BRAIN-TUMORS IN CHILDREN UNDER 2 YEARS - TREATMENT, SURVIVAL AND LONG-TERM PROGNOSIS
BRAIN-TUMORS IN CHILDREN UNDER 2 YEARS - TREATMENT, SURVIVAL AND LONG-TERM PROGNOSIS
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DOI：
10.1159/000120727
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发表时间：
1993-07-01
影响因子：
0.7
通讯作者：
SCHUT, L
中科院分区：
文献类型：
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作者：
COHEN, BH;PACKER, RJ;SCHUT, L
诊断时小于2岁的脑肿瘤儿童的生存率很低，长期生存者的生活质量很差。在1975年至1987年期间，费城儿童医院治疗的579例脑肿瘤患者中有78例（13%）年龄在2岁以下。肿瘤位于后颅窝31例（40%），幕上47例（60%）。37例恶性肿瘤患者中有9例（24%）存活，41例良性肿瘤患者中有30例（73%）存活，平均随访116个月。单纯化疗后长期生存10例，其中恶性肿瘤3例。在另外5名患者中，化疗延迟了平均30个月的放疗需求。在初始治疗后复发的29名患者中，12名患者在复发后平均80个月存活，无疾病进展（2名恶性肿瘤患者和10名良性肿瘤患者），2名儿童在复发后平均48个月（范围9-115个月）死亡。39名幸存者中有21人有轻微或没有神经或智力功能障碍。手术和化疗治疗的存活患者比手术和放疗（有或没有化疗）治疗的患者有更好的智力功能，其中10名接受手术和化疗的儿童中有8名智力正常或高于正常，而12名接受放疗的儿童中有5名在2岁之前。
Survival for children with brain tumors less than 2 years of age at diagnosis is dismal, and the quality of life of long-term survivors poor. Between 1975 and 1987, 78 (13%) of 579 patients with brain tumors treated at Children's Hospital of Philadelphia were under 2 years of age. Tumor site was posterior fossa in 31 (40%) and supratentorial in 47 (60%). Nine of 37 patients (24%) with malignant tumors, and 30 of 41 (73%) patients with benign tumors are alive with a mean follow-up of 116 months. Long-term survival after treatment with chemotherapy alone occurred in 10 patients, including 3 with malignant tumors. In 5 additional patients, chemotherapy delayed the need for irradiation a mean of 30 months. Of the 29 patients who relapsed after initial therapy, 12 are alive without progressive disease (2 patients with malignant tumors and 10 with benign tumors) a mean of 80 months after relapse, 2 children are alive with progressive disease, and 14 died a median of 48 months (range 9-115 months) after relapse. Twenty-one of the 39 survivors have minimal or no neurological or intellectual dysfunction. Surviving patients treated with surgery and chemotherapy have better intellectual function than patients treated with surgery and radiation (with or without chemotherapy) in that 8 of 10 children treated with surgery and chemotherapy have normal or above normal intelligence compared with 5 of 12 children receiving irradiation before their second birthday.