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目的:对颅内生殖细胞肿瘤的诊断和综合治疗进行分析和总结。方法:回顾10年间34例颅内生殖细胞肿瘤,其中生殖细胞瘤20例,畸胎瘤7例,高度恶性非生殖细胞瘤性生殖细胞肿瘤7例。结果:20例生殖细胞瘤中15例行脑室腹腔分流术,19例放射治疗,2例联合化疗,5例复发;畸胎瘤7例全部手术切除,除1例恶性畸胎瘤外其他6例无复发;7例高度恶性非生殖细胞瘤性生殖细胞肿瘤中1例行γ-刀治疗后手术治疗,2例行放疗联合药物化疗,随访1～3年并存活至今,其他4例均于1年内死亡。结论:颅内生殖细胞瘤的首选治疗方法是放疗,并联合化疗;畸胎瘤者应予手术切除,其中恶性畸胎瘤者应加用足量放疗和化疗;高度恶性非生殖细胞瘤性生殖细胞肿瘤应用“三明治”疗法,先化疗观察肿瘤标志物降低情况,接着足量放疗(50～60Gy),待肿瘤标记物正常时,如仍有肿瘤残存可再手术切除,如肿瘤标记物仍高,则继续化疗和(或)放疗。
Objective: To analyze and summarize the diagnosis and comprehensive treatment of intracranial germ cell tumors. Methods: A retrospective study of 34 cases of intracranial germ cell tumors in 10 years, including 20 cases of germ cell tumor, 7 cases of teratoma and 7 cases of highly malignant non-germ cell germ cell tumor. Results: In 20 cases of germinoma, 15 cases underwent peritoneal shunt, 19 cases received radiotherapy, 2 cases combined chemotherapy and 5 cases relapsed. All 7 cases of teratoma were surgically removed, except 6 cases of malignant teratoma No recurrent; 7 cases of highly malignant non-germ cell germ cell tumors in 1 case after γ-knife surgery, 2 cases of radiotherapy combined with drug chemotherapy, followed up for 1 to 3 years and survived so far, the other 4 cases were in 1 Death during the year. Conclusion: The preferred treatment of intracranial germinomas is radiotherapy combined with chemotherapy; teratoma should be surgically removed, of which malignant teratoma should be treated with adequate radiotherapy and chemotherapy; highly malignant non-germ cell tumor of the reproductive Cell tumor application “sandwich ” therapy, the first chemotherapy to observe the reduction of tumor markers, followed by adequate radiotherapy (50 ~ 60Gy) until the tumor marker is normal, if there is still tumor remaining resectable, such as tumor markers Still high, then continue chemotherapy and / or radiotherapy.