【摘要】 目的探讨颅内恶性脑膜瘤的临床特点、影像学特点、治疗手段及预后影响因素。方法回顾性分析2008年4月至2018年4月开颅手术肿瘤的34例恶性脑膜瘤的临床资料。结果肿瘤全切(SimpsonⅠ～Ⅲ级)20例,非全切(SimpsonⅣ～Ⅴ)14例;术后行放疗19例,未行放疗15例。术后病理示,横纹肌样恶性脑膜瘤17例,乳头型恶性脑膜瘤6例,间变型恶性脑膜瘤11例。生存曲线分析显示,肿瘤全切病人生存期较非全切病人明显延长(P=0.002);术后放疗病人生存期较未放疗病人延长,但无统计学差异(P=0.078)。结论对恶性脑膜瘤的治疗,手术切除程度至关重要,直接影响病人生存期;术后放疗可抑制肿瘤短期内复发,但对病人长期预后无显著影响。更多还原

【Abstract】 Objective To explore the clinical manifestations, imaging features, treatment and factors related to prognoses in patients with intracranial malignant meningiomas(ICMM). Methods The clinical data of 34 patients with ICMM undergoing craniotomy in Tongji Hospital from April, 2008 to April, 2018 were analyzed retrospectively. The factors related to prognoses were statistically analyzed in the patients with ICMM. Results Of 34 patients with ICMM, 17 were rhabdoid malignant meningiomas, 6 papillary malignant meningiomas, and 11 metastatic malignant meningiomas. The tumors were totally resected(Simpson grades Ⅰ～Ⅲ) in 20 patients and subtotally(Simpson Ⅳ～Ⅴ) in 14. Of these 34 patients, 19 received radiotherapy and 15 not after the surgery. The survival time were significantly longer in patients with ICMM receiving totally resection of the tumor than those in the patient with ICMM who received incomplete resection of the tumors. Conclusions The extent of surgical resection of the tumors is the key to prolonging the survival time,and the postoperative radiotherapy can inhibit the recurrence of tumors in the short term, but it has no significant effect on the long-term prognoses in the patients with ICMM.更多还原