橋腫瘍長期生存例の検討

STUDY OF LONG SURVIVAL TERM IN PONTINE TUMORS

I．はじめに

　Pons glioma又はbrain stem glioma等と呼ばれる脳幹部髄内腫瘍（以下pons tumorと略す）は，手術及び各種補助療法を加えても神経症状の一時改善はともかく，一般には余り延命効果は期待されない。しかも殆んどが術後約1年以内に死亡すると云われている。しかし種々の治療で時に5年以上の生存例も経験されている。そこで今回はpons tumorの生存期間，特に長期生存例をとりあげて検討してみた。

　われわれが過去16年間，虎の門病院及び杏林大学脳神経外科にて経験したpons tumorは24例である。この中，剖検し得た13例の生存期間，治療効果及び神経症状の推移について，主として臨床的特性を中心に分析し，長期生存に関係があると思われる因子について考えてみた。

1) Twenty-four cases of pontine tumors weretreated over sixteen years at Toranomon Hospitaland Kyorin Medical School. There was discussionabout the survival terms, especially those of longsurvival term, based upon the thirteen cases whichwere examined by autopsy.

2) Age of onset was between five and sixty years,and the infantile cases were five out of thirteen.

3) The average survival term was about ninemonths excluding the two long survival cases, onewas four years and seven months and the otherwas fourteen years and ten months.

4) The longer the survival term was, the morethe neurological symptoms could be detected. Butthere was no relation between the cranial nerveinvolvements and the survival term. On the otherhand, in long survival cases, improvement of cranialnerve disorders was more prominent than otherneurological disturbances.

5) In long survival cases, the term from onsetto admission was longer than in other cases. Butat autopsy there was no relation between histologicalfindings and survival term.