摘要
对４８例经手术治疗、术后放疗和（或）化疗后复发的胶质瘤进行了伽玛刀治疗，肿瘤直径１１．３～６９．８ｍｍ，平均３５ｍｍ；肿瘤中心剂量２２～５５Ｇｙ，平均３２Ｇｙ；肿瘤周边剂量１１～２０Ｇｙ，平均１５Ｇｙ；照射的等中心数１～１５个，平均７个。获得随访４０例，随访时间９～２２个月，平均１４个月。至最后一次随访时，１６例死亡，１２例病情恶化，３例症状好转，９例病情无加重。４０例的存活时间２～２２个月，平均１０．９个月。肿瘤体积小治疗效果好，体积大效果差。
orty-eight patients who had recurrent glioma after surgical resection, radiation therapy and/orchemotherapy, were treated with gamma kuife radiosurgery.The maximum diameter of tumor rangedfrom 11.3 to 69.8mm(mean,35mm)and most lesions required mutiple-shot dose plans,with an averageof 7 shots per patient(range 1-15 shots).The mean dose administered to tumor center and margin was32.4Gy(22-55Gy)and 15.1Gy(11-20Gy)respectively with 30-60% isodose line to the tumor margin. Forty patients underwent follow-up from 9 to 22 months.At last follow-up,there were 16 patients dead,twelve with deteriorated clinical status,three patients with postoperative imaging decreased in tumor sizesand improved in neurological deficits,nine remained neurological stable. The mean survival in this serieswas 10.9 months. The preliminary results showed that the patients with smaller lesions had comparablylonger survival than the patients with larger lesions.
