恶性脑膜瘤的临床特点及治疗

摘要

Objective To analyze the characteristics and treatment of malignant meningiomas. Methods A total of 12 cases of malignant meningiomas were analyzed retrospectively for the general conditions, CT or MRI manifestations, treatments and pathological features. Results Sex ratio ( male/female) was 2:1; gross total resection (Simpson I) was performed in 7 cases, and subtotal resection (Simpson II) in 5 cases. Recurrence rate was 57.14% and 80% for two groups, respectively. Survival rate at 1, 2, and 5 years following resection were 91.7% , 83.3% , and 58.3% , respectively. Pathological examination confirmed 7 cases of WHO II and 5 cases of WHO M. Eight cases were performed the surgery with the neuronavigation. No post-operative complication was found. Conclusion Surgical resection and post-operative radiotherapy is the primary choice for the treatment of malignant meningiomas. Total resection is helpful for the decreasing of recurrence of malignant meningiomas. Neuronavigation is useful for the protection of brain functional area.%目的 总结恶性脑膜瘤的临床特点,探讨最佳治疗手段.方法 回顾性分析12例恶性脑膜瘤患者的一般情况、影像学特点、治疗方法以及病理特点等.结果 12例患者中男女比例为2:1;7例行肿瘤全切(Simpson Ⅰ级),5例行肿瘤次全切(SimpsonⅡ级),5年内肿瘤复发率分别为57.14％和80％；术后1年,2年及5年的生存率分别为91.7％,83.3％及58.3％；术后病理报告WHOⅡ级有7例,WHOⅢ级有5例；神经导航下手术8例,术后无神经功能障碍发生.结论 手术切除+术后放疗是治疗的首选方式,手术全切能够降低肿瘤的复发率,神经导航的应用能够有效保护功能区.