小脳astrocytoma28例の遠隔成績 : 手術方法および照射療法の可否について

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Twenty-eight patients with cerebellar astrocytoma were treated at the Department of Neurosurgery, Brain Research Institute, Niigata University, between 1947 and 1980. There was one surgical death and two additional patients who died prior to posterior fossa surgery and were confirmed to have a cerebellar astrocytoma by autopsy. Thus, 25 patients were available for follow-up analysis. The surgical procedures, histological findings and the efficacy of radiation therapy as well as the clinical symptoms and signs have been presented. Thirteen patients were under 15 years of age and 15 were over 16 years old. Eight patients died in the period from 9 months to 9 years (mean 2.6±2.7 years) after posterior fossa surgery. Out of a total of 28 patients, 17 have survived for 1 to 26 years, and 13 of the 17 survivors have survived 10 to 26 years after their tumors had been operated on. Among 15 patients who received partial excision of the tumor, eight are surviving and seven of them were irradiated. Four of the five patients who underwent subtotal excision are surviving. All of the five patients of total excision are surviving. All of the living patients were found to be in excellent or good neurological condition. Radiation therapy was performed on 18 patients after posterior fossa surgery. Among 17 patients whose tumors were not totally excised during surgery, eight of 12 patients with radiation therapy are surviving, while only one of five patients without radiation therapy are surviving. Sixteen out of 19 patients whose tumors were diagnosed as piloid, fibrillary or spongioblastic astrocytoma histologically are surviving. However, only one of six patients whose tumors were diagnosed as protoplasmic, diffuse-type or anaplastic astrocytoma have survived. It is advocated that every effort should be made to extirpate the solid portion of the tumor as much as possible. However, if the tumor has invaded deeply into the brain stem or the floor of the fourth ventricle, surgical intervention should be stopped to avoid postoperative morbidity. Postoperative radiotherapy seems to have some effect on the prevention of recurrence of the tumor.
日本脳神経外科学会の論文
1982-02-15

小脳astrocytoma28例の遠隔成績 : 手術方法および照射療法の可否について

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