目的　观察颅内生殖细胞瘤经过化疗并辅以中低剂量放疗后的疗效及对儿童生长发育的影响。方法　自 1 993年 1 2月至 2 0 0 1年 1 2月共对 63例颅内生殖细胞瘤的儿童进行静脉化疗并辅以中低剂量放疗 ,随访到 34例 ,其中肿瘤位于松果体区 2 0例 ,松果体区并鞍区 6例 ,鞍区 4例 ,松果体区并脑室内 3例 ,底节区 1例。使用药物为长春新碱、甲氨蝶呤、平阳霉素及顺铂。用药后每周化验 2次血常规 ,1次血生化 ,以观察周围血象变化及心、肝、肾功能情况 ,并进行针对性治疗。 4周后如血常规及血生化的各项指标均正常 ,再行第二疗程化疗。 2个疗程结束后 1个月 ,在肿瘤病灶局部补充中低剂量 (2 5～ 35Gy)的放疗。每个疗程间进行CT或MRI检查 ,观察肿瘤消退的情况。结果　 34例患者随访最短 1年 ,最长 7年。 1例为手术加全剂量放疗后 2年肿瘤复发 ,此次化疗进行 2个疗程 ,但化疗后未再补充放疗 ,4年后肿瘤复发 ,家属放弃治疗 ,患者死亡。 1例化、放疗后 5年肿瘤复发 ,再行 2个疗程化疗 ,疗效较首次治疗差。其余 32例 (94% )化、放疗后 1～ 7年 ,复查MRI显示肿瘤无复发 ,患者生存质量良好 ,儿童生长发育及智力均未受影响。结论　静脉化疗辅以中低剂量放疗应为治疗儿童颅内生殖细胞瘤的最佳方案 Objective To observe the effect of intracranial germinoma after chemotherapy combined with low and middle dose radiotherapy on the growth and development of children. Methods From January 1993 to February 2001, 63 children with intracranial germinomas were treated with intravenous chemotherapy supplemented with low and medium dose radiotherapy. 34 patients were followed up, in which the tumor located in the pineal gland There were 20 cases in the region, 6 cases in the pineal region and the saddle region, 4 in the saddle region, 3 in the pineal region and the cerebral ventricle, and 1 in the basal ganglia. Drugs used for vincristine, methotrexate, Pingyangmycin and cisplatin. Blood samples were tested twice a week after treatment, blood biochemistry, in order to observe changes in peripheral blood and heart, liver and kidney function, and targeted treatment. After 4 weeks, such as blood and blood biochemical indicators were normal, then the second course of chemotherapy. One month after the end of the 2 courses of treatment, low-dose (25-55 Gy) radiotherapy was locally added to the tumor lesions. CT or MRI examination of each course of treatment to observe the tumor regression. Results 34 patients were followed up for a minimum of 1 year, up to 7 years. One patient had tumor recurrence 2 years after operation and full dose of radiotherapy. The chemotherapy was carried out for 2 cycles. However, radiotherapy was not given after chemotherapy. After 4 years, the tumor recurred and the family gave up treatment. The patient died. 1 cases, 5 years after radiotherapy tumor recurrence, followed by two courses of chemotherapy, the first treatment is worse than the efficacy. The remaining 32 cases (94%), radiotherapy 1 to 7 years after the review of MRI showed no recurrence of tumor, good quality of life of patients, children’s growth and development of intelligence were not affected. Conclusion Intravenous chemotherapy supplemented with low-dose radiotherapy should be the best treatment for children with intracranial germinoma