探讨关于松果体区肿瘤治疗方式的选择。

回顾性分析解放军第九六〇医院神经外科自2004年9月至2016年12月收治的21例松果体区肿瘤患者的临床资料，根据不同的组织学类型对患者采用不同的治疗方式，并随访观察预后情况。

本组患者中显微手术9例，穿刺活检4例，脑室镜下活检4例，脑室-腹腔分流术后行实验性放射治疗4例。死亡2例，19例随访6个月~15年，生活自理、轻残者8例，中残者4例，重残者1例，失访者6例。

松果体区肿瘤应根据肿瘤的组织学类型、患者年龄、是否合并脑积水而决定治疗方式：生殖细胞瘤者尽快选择全脑、全脊髓放射治疗，儿童生殖细胞瘤者建议先行化学治疗后再行低剂量的放射治疗，合并脑积水的患者应解除脑积水症状后再行其他治疗。

To explore the choice of treatment methods for pineal region tumors.

The clinical data of 21 patients with pineal region tumors admitted to the Department of Neurosurgery of the 960^th Hospital of PLA from September 2004 to December 2016 were retrospectively analyzed. Different treatment methods were adopted according to different histological types, and the prognosis was followed up.

There were 9 cases of microsurgery, 4 cases of puncture biopsy, 4 cases of ventriculoscopic biopsy, and 4 cases of experimental radiotherapy after ventriculoperitoneal shunt. Two cases died, 19 cases were followed up for 6 months to 15 years, 8 cases were self-care, mild disability, 4 cases were moderate disability, 1 case was severely disabled, 6 cases were lost.

Pineal region tumors should be treated according to the histological type of tumors, patient’s age and whether hydrocephalus occurs or not. Germinoma patients should choose whole brain and spinal cord radiotherapy as soon as possible. Children with germinoma should be treated with low dose radiotherapy after chemical therapy. Patients with hydrocephalus should be relieved of hydrocephalus symptoms before other treatments.