摘要
目的：探讨立体定向放射手术伽玛刀（γ－刀）对颅内疾病的疗效。方法：用1．5Tesla磁共振仪和γ－plan计算机联网定位，γ－plan4．0版剂量规划系统作治疗方案设计，剂量规划，并用Leksellγ－刀对3094例不同类型的颅内疾病包括肿瘤、血管畸形及功能性疾病等实施立体定向放射手术，病种达20余种，年龄1．1—86岁，周边剂量9－75Gy，中心剂量18－150Gy，等剂量曲线30％－90％，靶点数1－12个。结果：随访10－47个月，统计结果表明：γ－刀疗效是确切的。脑动静脉畸形，随防一年半以上，完全闭塞率可达44．6％，体积越小，周边照射剂量越大，闭塞率越高。颅内肿瘤的生长控制率，良性肿瘤≥80．0％，恶性肿瘤≥66．7％。功能性疾病的治疗有效率，帕金森病为85．2％，三叉神经痛为76．9％，痴痴是66．7％。结论：γ－刀立体定向放射手术较常规开颅手术安全，痛苦少，是治疗颅内一些疾病有效的方法。严格掌握治疗指征，精确定位，合理剂量规划，可确保疗效，降低并发症。
Object To explore the therapeutic efficiency of the intracranial diseases with the gamma knife stereotactic radiosurgery. Method 3094 cases with different intracranial diseases including brain tumor, arieriovenous malformation (AVM), functional disorders et al were treated by Leksell gamma knife. The localization of the treatment was used by 1. 5 Tesla MRI and transmit the images from the network workstation to the gamma plan system to make dose plans. The patient ages ranged from 1. 1 to 86 years. The adIninistered peripheral dose was 9 to 75 Gy, center dose was 18 to 150 Gy, The number of shots were 1 ~ 12 shots. Result The 10 ~ 47 months followed - up indicated that the treatment result of gamma knife was satisfied. For AVM of followed - up 1. 5 years, the complete obliteration rate was more than 44. 6%. The smaller was the volume of AVM, or the larger peripheral dose was, the higher obliteration rate was. The growth control rate of tumor were the benign tumors> 80. 0%, and malilgnant tumors > 66. 7%, respectively. The effective rates of functional disorders, parkinson's diseases, primary trigminal neuralgia and epilepsy respectively were 85. 2%, 76. 9%, and 66. 7%. Conclusion The gaxnma knife radiosurgery is a effective method to treat intracranial diseases safely and painless than cranioactomy. The rigid application of the indications, acurate localization and rational plan of the administered dose can ensure the theraputic efficiency and decrease complications.
出处
《中国微侵袭神经外科杂志》
CAS
1999年第4期9-12,共4页
Chinese Journal of Minimally Invasive Neurosurgery
