[1]邬迎喜 薛亚飞 赵兰夫 赵天智 吕文海 陆 丹.颅底与颈椎脊索瘤13例临床分析[J].中国临床神经外科杂志,2015,(09):517-519.[doi:10.13798/j.issn.1009-153X.2015.09.002]
 WU Ying-xi,XUE Ya-fei,ZHAO Lan-fu,et al.Clinical analysis of 13 cases of chordomas in the skull base and cervical vertebrae[J].,2015,(09):517-519.[doi:10.13798/j.issn.1009-153X.2015.09.002]
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颅底与颈椎脊索瘤13例临床分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2015年09期
页码:
517-519
栏目:
论著
出版日期:
2015-09-30

文章信息/Info

Title:
Clinical analysis of 13 cases of chordomas in the skull base and cervical vertebrae
文章编号:
1009-153X(2015)09-0517-03
作者:
邬迎喜 薛亚飞 赵兰夫 赵天智 吕文海 陆 丹
710000 西安 ,第四军医大学唐都医院神经外科
通讯作者:赵天智,E-mail:ares1102@126.com
Author(s):
WU Ying-xi XUE Ya-fei ZHAO Lan-fu ZHAO Tian-zhi LV Wen-hai LU Dan.
Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi’an 710000, China
关键词:
脊索瘤颅底颈椎显微手术鼻内镜
Keywords:
Chordomas Skull base Cervical vertebrae Microneurosurgery Endonasal endoscope Transnasophenoidal
分类号:
R 739.41; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2015.09.002
文献标志码:
A
摘要:
目的 探讨颅底及颈椎脊索瘤手术治疗方法及疗效。方法 回顾性分析2009年3月至2013年10月收治的13例颅底及颈椎脊索瘤患者临床资料。根据肿瘤生长部位及特点,包括原发及复发病例,颅底脊索瘤分别采用经鼻蝶入路7次、经鼻蝶联合经口入路2次、翼点入路1次和乙状窦后入路2次;颈椎脊索瘤采用颈椎后路切除及内固定术4次。结果 13例病人术后随访2~60个月,平均随访21个月。首次手术后全切除7例(53.8%),次全切除4例(30.8%),部分切除2例(15.4%)。术后行放射治疗7例。术后复发4例,3例再次行手术治疗,1例行放射治疗。结论 依据肿瘤的生长部位和特点选择合适的手术入路是颅底和颈椎脊索瘤手术成功的关键,经鼻蝶入路鼻内镜辅助下手术为颅底脊索瘤提供了一种更加安全和有效的全切除肿瘤的方法,术后给予放射治疗可以延缓肿瘤的复发。
Abstract:
Objective To study surgical treatments of chordomas in skull base and cervical vertebrae and its effect. Methods The clinical data of 13 patients with chordomas treated in our neurosurgery center from March, 2009 to October, 2013 were analyzed retrospectively. The neurosurgical procedures performed according to the location and characteristics of tumors included transnaso- sphenoidal approach in 6 patents, transnasosphenoidal combined with transoral in 2, via pterional in 1, via retromastoid in 1 and via posterior cervical approach and internal fixation in 3. Results All the patients were followed up from 2 to 60 months (mean, 21 months). The postoperative MRI showed that of 13 patients, 7 received the total resectionof the tumors, 4 subtotal and 2 part. The tumors recurred in 4 patients, of whom, 3 underwent surgery again and 1 received radiotherapy. Conclusions It is the key to the success of skull base and cervical vertebrae surgery for chordomas to choose an appropriate approach according to the location and characteristics of tumors. The endoscope-assisted transnasophenoidal surgery is a safe and effective method to treat the chordomes in the skull base and cervical vertebrae, but it needs to be improved and enhanced. Postoperative radiotherapy may prevent the recurrence of the chordomas.

参考文献/References:

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[2] Bergh P, Kindblom LG, Gunterberg B, et al. Prognostic fac- tors in chordoma of the sacrum and mobile spine: a study of 39 patients [J]. Cancer, 2000, 88(9): 2122-2134.
[3] Schwab JH, Boland PJ, Agaram NP, et al. Chordoma and chondrosarcoma gene profile: implications for immuno- therapy [J]. Cancer Immunol Immunother, 2009, 58(3): 39- 49.
[4] McMaster ML, Goldstein AM, Bromley CM, et al. Chordoma: incidence and survival patterns in the United States, 1973- 1995 [J]. Cancer Causes Control, 2001, 12(1): 1-11.
[5] Fatemi N, Dusick JR, Gorgulho AA, et al. Endonasal micro- scopic removal of clival chordomas [J]. Surg Neurol, 2008, 69(4): 331-338.
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备注/Memo

备注/Memo:
基金项目:第四军医大学唐都医院新技术新业务支柱
更新日期/Last Update: 2015-09-30