摘要
目的总结评价伽玛刀(γ刀)放射外科治疗听神经瘤的中长期效果。方法78例患者平均年龄45.0±17.9岁,男性35例,女性43例;单侧病变74例,双侧4例;20例曾行手术治疗;57例γ刀治疗前存在有用听力;肿瘤容积0.11～27.8ml,平均10.8ml;边缘剂量10～14Gy,平均12.27Gy,中心剂量21～30Gy,平均24.90Gy。结果随访22～96个月,平均58.3±22.9个月;63例(80.8%)肿瘤缩小,12例(15.4%)大小无变化,3例(3.8%)肿瘤增大;47例患者有用听力得到保留,其中13(22.8%)例较术前明显改善;3例(3.8%)出现患侧面瘫;5例(6.4%)出现三叉神经功能部分受损。结论γ刀治疗听神经瘤中、长期疗效分析显示既可控制肿瘤生长又取得较高的神经功能保留率,值得推广。
Objective To assess the results of gamma knife radiosurgery for vestibular schwannomas. Methods We evaluated 78 consecutive patients （35 men and 43 wemen） by means of serial imaging tests, clinical evaluations and questionnaires. Seventy-four of them had solitary tumors; only four with bilateral lesions. Prior resection had been performed in 20 patients. Facial nerve function was normal in 80.8 % of the patients before radiosurgery,and 73.1% of them had serviceable hearing. Prescription peripheral dose varied from 10 to 14 Gy （mean 12.27 Gy）;the corresponding central dose was 21 to 30Gy （mean 24.9 Gy）. The mean volume of the tumor at radiosurgery was 10.8ml （range,0.11 to 27.8 ml）. An average of 8 isocenters （range,3 to 17） were used for treating these lesions. Resuits At a median follow-up period of 58.3 months （range, 22 to 96months）, tumor shrinkage was observed in 63 cases （80.8 % ）, and tumor size was stable in 12 cases（ 15.4 % ）. Only 3 cases（3.8 % ）showed persistent radiographic evidence of progression （2 patients received repeated radiosurgery after an interval of 18 months,the other is under further observation）. Five patients experienced trigeminaldysfunction, three of whom were transient and in the other two were persistent. Three patients had facial palsy. Useful hearing was preserved in 47 patients, thirteen of which showed improvement in hearing. Deterioration of hearing was found in 13 out of 57 cases who had useful hearing before treatment.Conclusion Gamma knife radiosurgery prevents tumor growth,achieves excellent neurologic function preservation rates and few treatment - related complications.
出处
《立体定向和功能性神经外科杂志》
2005年第4期225-229,共5页
Chinese Journal of Stereotactic and Functional Neurosurgery
关键词
听神经瘤
伽玛刀
放射外科
Vestibular schwannoma
Gamma knife
Radiosurgery
