摘要
目的总结评价伽玛刀(γ刀)治疗颅底良性脑膜瘤的长期疗效。方法217例患者平均年龄52.2±13.8岁(9～83岁),男性65例,女性152例;病史0.5～216个月,平均35.5个月,中位时间26个月;105例曾行手术治疗;肿瘤容积0.41～42.8cm3,平均6.8±6.1cm3;均行增强MRI定位扫描;边缘剂量10～20Gy,平均13.9±1.8Gy,中心剂量22.2～40Gy,平均27.7±4.6Gy;等剂量曲线40%～60%,平均49.53%;等中心数2～20个,平均10个。结果随访36～120(平均69.8±21.8)个月,肿瘤控制率为97.7%(212/217);临床表现:130例(59.9%)好转,78例(35.9%)稳定,9例(4.1%)恶化;9例曾出现一过性症状加重;2例(0.9%)出现放射性水肿;6例(2.8%)于γ刀后行显微外科手术切除。结论伽玛刀治疗颅底脑膜瘤可长期控制肿瘤生长,并发症较少,能保证患者良好的生存质量,即为术后残留或复发的患者提供了进一步治疗的方法,也为较小颅底脑膜瘤患者治疗的主要疗法。
Objective To evaluate the effectiveness and toxicity of gamma knife radiosurgery （GKRS） for benign skull base meningiomas in 217 patients with a follow up of 3-10 years and to define the role of GKRS for basal meningiomas. Methods We evaluated 217 consecutive patients （65 men and 152 wemen） by means of serial imaging tests,clinical evaluations and questionnaires. Prior resection had been performed in 105 patients,and GKRS was performed as the sole treatment option in 112 patients. Prescription peripheral dose varied from 10 to 20Gy （mean 13.9Gy） ;the corresponding central dose was 22.2 to 40Gy （mean 27.7 ±4.6Gy）. The mean volume of the tumor at GKRS was 6.8ml （range,0.41 to 42.8ml）. An average of 10 isocenters （range,2 to 20） were used for treating these lesions. Results The tumor control rate is 97.7 % at a median follow-up period of 69.8 ±21.8 months. Only 2 cases（0.9 % ） experienced radiation-induced edema. The neurological status improved in 130 cases （59.9 % ）, remained unaltered in 78 cases （35.9 % ）, and deteriorated in 9 cases （4.1% ）. Repeated microsurgical resection was performed in six patients following GKRS. Conclusion Gamma knife radiosurgery achieves excellent long term tumour control rate and low morbidity for adjunctive and primary treatment of patients with basal meningiomas. This treatment option should be used more frequently in the therapeutic management of benign skull base meningiomas.
出处
《立体定向和功能性神经外科杂志》
2005年第6期339-341,共3页
Chinese Journal of Stereotactic and Functional Neurosurgery
关键词
脑膜瘤
伽玛刀
放射外科
Skull base meningioma
Gamma knife
Radiosurgery
