Treatment Strategies of the Pineal Region Tumors_West China Medical Journal

Authors：

MOU Kejie , MAO Qing , LIU Yanhui

Department of Neurosurgery，West China Hospital，Sichuan University，Chengdu 610041，China;

Corresponding author：

Keywords：

松果体区肿瘤; 治疗策略; 手术治疗; 放射治疗

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目的：探讨松果体区肿瘤的治疗策略。方法:我院自2003年12月至2007年12月收治的58例松果体区肿瘤，按肿瘤标志物甲胎蛋白（AFP）和人β促绒膜性腺激素（hCG-β）将其分为标志物增高组和正常组，回顾分析两组临床资料和治疗体会。结果:肿瘤标志物正常组36例，其中27例行手术切除肿瘤，9例行伽马刀治疗（其中5例行伽马刀加脑室腹腔分流治疗）。术后4例因病理报告示生殖细胞瘤行伽马刀补充治疗，3例因梗阻性脑积水行脑室腹腔分流。增高组22例，均选用伽马刀治疗（其中17例合并梗阻性脑积水者行伽马刀加脑室腹腔分流）。治疗后3例因症状缓解不佳行手术切除肿瘤术。手术病例中24例采用经胼胝体入路，4例经枕部小脑幕入路，2例经幕下小脑上入路。手术全切24例，次全切5例，部分切除1例，术后住院期内死亡者1例。病理诊断:生殖细胞瘤14例，畸胎瘤5例，中枢神经细胞瘤4例，室管膜瘤2例，表皮样囊肿2例，脑膜瘤1例，胶质瘤1例，皮样囊肿1例。放射外科治疗病例中28例术后3个月临床症状明显改善，4例随访期内肿瘤无明显变化，3例肿瘤增大。2例放疗后出现鞍区转移。结论:松果体区肿瘤组织类型多样，应尽可能先明确肿瘤性质后选择合理治疗策略。

Citation： MOU Kejie,MAO Qing,LIU Yanhui. Treatment Strategies of the Pineal Region Tumors. West China Medical Journal, 2009, 24(1): 14-17. doi: Copy

1.	Grossman RG，Lxjfius CM.王任直主译.Principles of Neurosurgery[M].北京:人民卫生出版社，2002:437-443..
2.	Gerhard P.Management of pineal region tumors[J].Neurosurg Q，2002，12（4）:279-298. [3]Araki C，Matsumoto S.Statistical reevaluation of pinealoma and related tumors in Japan[J].J Neurosurg，1969，30:146-149..
3.	Sano K.Diagnosis and treatment of tumors in the pineal region[J].Acta Neurochir （Wien），1976，34:153-157..
4.	王立根，郭艳，章翔，等.立体定向放射神经外科治疗松果体区肿瘤[J].立体定向和功能性神经外科杂志，2001，14（2）:86-88..
5.	Friedman WA，Foote KD.Linear accelerator radiosurgery in the management of brain tumors[J].Ann Med，2000，32:64..
6.	漆松涛，张喜安，潘军.显微手术切除松果体区肿瘤（附34例报告）[J].中国神经精神疾病杂志，2003，29（4）:265-268..
7.	Oi S.Recent advences and racial diferences in therspeutic strategy to the pineal region tumor[J].Childs Nerv Syst，1998，14（12）:33-35..
8.	梁树立.松果体区肿瘤的外科治疗[J].国外医学神经病学神经外科学分册，2001，28（3）:149.
9.	〖ZK（#〗Fauchon F，Jouvet A，Paquis P，et al.Parenchymal pineal tumors:a clinicopathological study of 76 cases[J].Int J Radiat Oncol Biol Phys，2000，46（4）:959-968..
10.	Kang JK，Jeun SS，Hong YK.Experience with pineal region tumors[J].Childs Nerv Syst，1998，14（12）:63-68..
11.	Bruce JN，Ogden AT.Surgical strategies for treating patients with pineal region tumor[J].J Neurooncol，2004，69（13）:221-236..
12.	Konovalov AN，Pitskhelaur DI.Principals of treatment of the pineal region tumors[J].Surg Neurol，2003，59（4）:250-268..
13.	Pople IK，Athanasiou TC，Sandeman DR，et al.The role of endoscopic biopsy and third ventriculostomy in the management of pineal region tumors[J].Br J Neurosurg，2001，15（4）:305-311..
14.	Oi S，Kamio M，Joki T，et al.Neuroendoscopic anatomy and surgery in pineal region tumors:role of neuroendoscopic procedure in the ‘minimallyinvasive preferential’ management[J].J NeuroOncol，2001，54（3）:277-286..
15.	Chernov MF，Kamikawa S，Yamane F，et al.Neurofiberscopic biopsy of tumors of the pineal region and posterior third ventricle:indications，technique，complications，and results[J].Neurosurgery，2006，59（2）:267-277..
16.	Pople IK，Athanasiou TC，Sandeman DR，et al.The role of endoscopic biopsy and third ventriculostomy in the management of pineal region tumors[J].Br J Neurosurg，2001，15（4）:305-311.

1. Grossman RG，Lxjfius CM.王任直主译.Principles of Neurosurgery[M].北京:人民卫生出版社，2002:437-443..
2. Gerhard P.Management of pineal region tumors[J].Neurosurg Q，2002，12（4）:279-298. [3]Araki C，Matsumoto S.Statistical reevaluation of pinealoma and related tumors in Japan[J].J Neurosurg，1969，30:146-149..
3. Sano K.Diagnosis and treatment of tumors in the pineal region[J].Acta Neurochir （Wien），1976，34:153-157..
4. 王立根，郭艳，章翔，等.立体定向放射神经外科治疗松果体区肿瘤[J].立体定向和功能性神经外科杂志，2001，14（2）:86-88..
5. Friedman WA，Foote KD.Linear accelerator radiosurgery in the management of brain tumors[J].Ann Med，2000，32:64..
6. 漆松涛，张喜安，潘军.显微手术切除松果体区肿瘤（附34例报告）[J].中国神经精神疾病杂志，2003，29（4）:265-268..
7. Oi S.Recent advences and racial diferences in therspeutic strategy to the pineal region tumor[J].Childs Nerv Syst，1998，14（12）:33-35..
8. 梁树立.松果体区肿瘤的外科治疗[J].国外医学神经病学神经外科学分册，2001，28（3）:149.
9. 〖ZK（#〗Fauchon F，Jouvet A，Paquis P，et al.Parenchymal pineal tumors:a clinicopathological study of 76 cases[J].Int J Radiat Oncol Biol Phys，2000，46（4）:959-968..
10. Kang JK，Jeun SS，Hong YK.Experience with pineal region tumors[J].Childs Nerv Syst，1998，14（12）:63-68..
11. Bruce JN，Ogden AT.Surgical strategies for treating patients with pineal region tumor[J].J Neurooncol，2004，69（13）:221-236..
12. Konovalov AN，Pitskhelaur DI.Principals of treatment of the pineal region tumors[J].Surg Neurol，2003，59（4）:250-268..
13. Pople IK，Athanasiou TC，Sandeman DR，et al.The role of endoscopic biopsy and third ventriculostomy in the management of pineal region tumors[J].Br J Neurosurg，2001，15（4）:305-311..
14. Oi S，Kamio M，Joki T，et al.Neuroendoscopic anatomy and surgery in pineal region tumors:role of neuroendoscopic procedure in the ‘minimallyinvasive preferential’ management[J].J NeuroOncol，2001，54（3）:277-286..
15. Chernov MF，Kamikawa S，Yamane F，et al.Neurofiberscopic biopsy of tumors of the pineal region and posterior third ventricle:indications，technique，complications，and results[J].Neurosurgery，2006，59（2）:267-277..
16. Pople IK，Athanasiou TC，Sandeman DR，et al.The role of endoscopic biopsy and third ventriculostomy in the management of pineal region tumors[J].Br J Neurosurg，2001，15（4）:305-311.

West China Medical Journal

Treatment Strategies of the Pineal Region Tumors

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