期刊文献+

Leksell-C型伽玛刀治疗听神经瘤的长期疗效分析 被引量:6

Long-term outcomes of vestibular schwannomas following Leksell-C Gamma Knife radiosurgery treatment
下载PDF
导出
摘要 目的分析Leksell-C型伽玛刀治疗听神经的长期疗效。方法回顾性分析长期随访的64例听神经瘤的临床资料。其中曾行开颅手术17例,面神经功能正常53例,具备有用听力41例。肿瘤体积0.2~33.9cm3,平均7.7cm3;治疗周边剂量11.0~14.0Gy,平均12.7Gy;等剂量曲线40%~60%,靶点数2~15个,平均6个。结果随访46~81个月,平均62.2个月。肿瘤缩小52例,稳定9例;肿瘤增大3例,其中2例在3年后再次行伽玛刀治疗,随访显示肿瘤缩小,另1例在治疗后2年行开颅手术。发生面神经功能损伤2例,保留有用听力29例。发生三叉神经功能障碍8例(其中一过性损伤6例,损伤率为3.1%)。结论Leksell-C型伽玛刀放射外科治疗听神经瘤具有良好的肿瘤控制率和有用听力保留率,神经功能损伤发生率低,值得临床推广应用。 Objective To evaluate the long-term efficacy of Leksell-C Gamma Knife radiosurgery (GKS) for patients with vestibular schwannomas (VS). Methods Clinical data of 64 patients with VS were analyzed retrospectively, Seventeen cases ever received digging skull operation previously; 53 cases had normal facial nerve fimction; 41 patients had serviceable hearing. The mean tumor size was 7.7cm^3 (ranging from 0.2 to 33.9 cm^3). A mean peripheral dose prescription of 12.7 Gy was used (ranging from 11.0-14.0 Gy). The isodose curve varied between 40% and 60%. Two to fifteen targeting points were determined (mean 6). Results The follow-up period ranged from 46-81 (mean 62.2) months. Tumor shrinkage was observed in 52 patients. Tumor size was stable in 9 cases. Tumor enlargement was observed in 3 patients, among these, 2 underwent another GKS after 3 years and the follow-up visit showed tumor shrinkage; 1 underwent surgical removal after 2 years. Facial palsy was reported in 2 cases. Serviceable hearing was preserved in 29 patients. Eight patients experienced trigeminal dysfunction, including transient dysfunction in 6 cases (3.1%). Conclusion Leksell-C GKS shows satisfactory tumor size control effects and excellent serviceable hearing preservation efficacy in patients with VS. The risk of GKS treatment-related cranial nerve toxicities is low. Leksell-C GKS deserves clinical generalization.
出处 《中国微侵袭神经外科杂志》 CAS 北大核心 2009年第8期350-352,共3页 Chinese Journal of Minimally Invasive Neurosurgery
关键词 神经瘤 放射外科手术 治疗效果 neuroma, acoustic radiosurgery treatment outcome
  • 相关文献

参考文献12

  • 1SAMII M, GERGANOV V, SAMII A. Improved preservation of hearing and facial nerve function in vestibular schwannoma surgery via the retrosigmoid approach in a series of 200 patients [J]. J Neurosurg, 2006, 105(4): 527- 535.
  • 2ROSENBERG S I. Natural history of acoustic neuromas [J].Laryngoscope, 2000, 110(4): 497-508.
  • 3KONDZIOLKA D, LUNSFORD L D, MCLAUGHLIN M R, et al. Long-term outcomes after radiosurgery for acoustic neuromas [J]. N Engl J Med, 1998, 339(20): 1426-1433.
  • 4FLICKINGER J C, KONDZIOLKA D, NIRANJAN A, et al, Acoustic neuroma radiosurgery with marginal tumor doses of 12 to 13 Gy [J]. Int J Radiat Oncol Biol Phys, 2004, 60(1): 225-230.
  • 5PETIT J H, HUDES R S, CHEN T T, et al. Reduced-dose radiosurgery for vestibular schwannomas [J]. Neurosttrgery, 2001, 49(6): 1299-1307.
  • 6刘东,徐德生,张志远,张宜培,郑立高.伽玛刀治疗听神经瘤中、长期疗效分析[J].立体定向和功能性神经外科杂志,2005,18(4):225-229. 被引量:9
  • 7HASEGAWA T, KIDA Y, YOSHIMOTO M, et al. Evaluation of tumor expansion after stereotactic radiosurgery in patients harboring vestibular schwannomas [J]. Neurosurgery, 2006, 58(6): 1119-1128.
  • 8WOWRA B, MUACEVIC A, JESS-HEMPEN A, et al. Outpatient gamma knife surgery for vestibular schwannoma: definition of the therapeutic profile based on a 10-year experience [J]. J Neurosurg, 2005, (102 Suppl): 114-118.
  • 9POLLOCK B E. Management of vestibular sehwarmomas that enlarge after stereotactic radiosurgery: treatment recommendations based on a 15 year experience [J]. Neurosurgery, 2006, 58(2): 241-248.
  • 10LUNSFORD L D, NIRANJAN A, FLICKINGER J C, et al. Radiosurgery of vestibular schwannomas: summary of experience in 829 cases [J]. J Neurosurg, 2005, 102(Suppl): 195- 199.

二级参考文献17

  • 1孙时斌,刘阿力,罗斌,王美华,刘鹏.伽玛刀治疗听神经鞘瘤的MRI随访及临床分析[J].中华放射学杂志,2004,38(10):1042-1046. 被引量:11
  • 2Samii M, Matthies C. Gamma surgery for vestibular schwannoma [J]. J Neurosurg, 2000,92 (5) : 892 - 896.
  • 3Matthies C, Samii M. Management of vestibular schwannomas(acoustic neuromas) : the value of neurophysiology for intraoperative monitoring of auditory function in 200 cases[ J ]. Neurosurgery, 1997,40 (3) : 459 - 468.
  • 4De Salles AA, Frighetto L, Selch M. Stereotactic and microsurgery for acoustic neuroma : the controversy continues[ J ].Int J Radiat Oncol Biol Phys, 2003,56 (5):1215 - 1217.
  • 5Leksell L. A note on the treatment of acoustic tumours[J ].Acta Chir Scand, 1971,137(8) :763 -765.
  • 6Linskey ME. Stereotactic radiosurgery versus stereotactic radiotherapy for patients with vestibular sehwannoma:a Leksell Gamma Knife Society 2000 debate [J]. J Neurosurg,2000,93(Suppl 3) :90-95.
  • 7Flickinger JC. Kondziolka D, Niranjan A, et al. Acoustic neuroma radio,surgery with marginal tumor doses of 12 to 13 Gy[J]. Int J Radiat Oncol Biol Phys,2004,60 ( 1 ) :225-230.
  • 8Kondziolka D, Lunsford LD, McLaughlin M, et al. Longterm outcome after radio,surgery for acoustic neuromas[J].N Engl J Med, 1998,339(20) : 1426-1433.
  • 9Lunsford LD, Niranjan A, Kondziolka D, et al. Gamma knife radiosurgery for acoustic tumors[J ]. Tech Neurosurg, 2003,9(3) :128-135.
  • 10Niranjan A,Lunsford LD, Flickinger JC, et al. Dose reduction improves hearing preservation rates after intracanallcular acoustic tumor radio,surgery[J]. Neurosurgery, 1999,45(4) :753-765.

共引文献12

同被引文献75

引证文献6

二级引证文献11

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部