摘要
目的探讨旋转式γ-刀临床应用的安全性和有效性。方法首先对旋转式γ-刀治疗的安全性和有效性进行动物实验。在此基础上,本中心7年来用旋转式γ-刀治疗的颅内病变2895例,男1491例,女1404例,年龄2～86岁(平均44.1岁)。良性颅内肿瘤1322例,其中垂体腺瘤540例,脑膜瘤312例,颅咽管瘤185例,前庭神经鞘瘤113例;恶性肿瘤864例,其中脑胶质瘤351例,脑转移癌460例;脑动静脉畸形319例,脑功能性疾病250例。本文详细分析了各种肿瘤或病灶用γ-刀的治疗方式,使用剂量及定位方法等,对各种肿瘤治疗结果作了初步评估,并对可能发生的并发症与不良反应的处理进行了探讨。结果经过选择的良性病变,包括垂体腺瘤、脑膜瘤、前庭神经鞘瘤、脑动静脉畸形、颅咽管瘤等可达到治愈或好转的效果;对部分脑转移癌、脑胶质瘤等恶性肿瘤患者延长了生命,并提高了生存质量。γ-刀治疗后严重脑水肿发生率为0.73%。结论作者认为γ-刀是当代高科技的发展,用于治疗脑部疾病的一种高精度、高性能、高疗效的精尖手术仪器,可使许多危及人脑健康的疾病获得治疗。但若应用不当又可造成严重或致死性并发症。因此一定要严格按规程操作,仔细与严谨设计毁损靶点与准确剂量布局,术后定期随访观察,对可能出现的并发症,采取最有效措施,这样就能获取最佳结果?
Objective To explore the safety and efficacy of OUR Rotating Gamma System in neurosurgical clinical aplication. Methods Based on the animal experiments between December 1996 and December 2003 2895 patients with intracranial disease were treated using OUR Rotating Gamma System in Aohai Gamma Knife Center of Navy General Hospital of PLA. There were 1491 males and 1404 females and their ages ranged from 2 to 86 years mean 44.1 years. 1322 patients have benign intracranial tumors and of them 540 suffered from pituitary adenomas 312 meningiomas 185 craniopharyngiomas and 113 vestibular schwannomas. Malignant tumor was diagnosed in 864 patients and of them gliomas in 351 and metastatic tumors in 460. 319 patients have cerebral arteriovenous malformations AVMs and 250 have functional neurological disorders. Treatment technique of Gamma Knife Stereotactic Radiosurgerydose prescription and precise orientation performed in intracranial tumor or foci was analyzed and the preliminary outcome of treatment was evaluated in this study. In addition the management of the possible complication and adverse reaction was studied. Results Gamma Knife Stereotactic Radiosurgery alone or combined with other treatment procedures can cure some of selected patients with benign brain lesions including pituitary adenomas meningioma vestibular schwannomas AVMs and craniopharyngioma etc. And this treatment can also be benefit to some patients with malignant tumors. The incidence rate of radiation edema was 0.73%. Conclusions The authors suggest that Gamma Knife Stereotactic Radiosurgery is a very effective accurate and relatively safe neurosurgical tool used either as a primary or adjuvant procedure for treatment of intracranical pathologic processes however it might lead some severe or fatal complications if some inappropriate operation was made. Thus optimal result would not be obtained unless the careful and precise Gamma treatment planning based on the operative rules was performed and the effective management for complications in the periods of regular follow-up postoperatively was taken.
出处
《中华神经外科杂志》
CSCD
北大核心
2004年第6期441-446,共6页
Chinese Journal of Neurosurgery
