摘要
自１９８８年１月至１９９６年１月采用ＣＴ引导立体定向技术对３００例颅咽管瘤进行了３８５次瘤内置入放射性核素的治疗。其中男１８０例，女１２０例，年龄３～７４岁，平均３０．５岁。全部病例均有视路受损症状。ＣＴ或ＭＲＩ检查显示：囊性肿瘤１７５例，实体性肿瘤４０例，实体与囊腔并存８５例，无，手术死亡及严重并发症。结果：术后２５０例随访６个月至８年，平均４年：肿瘤消失１８０例（７２％）；肿瘤显著缩小（＞８０％）３０例（１２％）；肿瘤缩小５０％左右２０例（８％）；肿瘤增大（主要为实体性）１６例（６．４％）；死亡４例（１．６％）。所使用的Ｐ－３２和Ｙ－９０是纯Ｂｅｔａ射线源，因其穿透能力短易于运送与保存、保护、对使用囊壁的治疗量为２００Ｇｙ（２００００ｒｄ）为好，可杀死瘤细胞而对周围组织无损害。提示立体定向瘤内放射性核素行间质内照射是治疗颅咽管瘤的一种有效方法。
tereotactic intratumour irradiation with instillation of nuclide colloid was performed in 220 patients with craniopharyngiomas (alltogether 265 times). Of them, there are 130 males, 90 females and their ages are ranged from 5 to 69 years old. All of them presented optic path impaired syndroms. CT or MRI scan showed cystic tumour in 125 cases, solid and cystic in 30 and solid in 15. There were no severely complication and death related to the operation. 150 cases were fowlled-up from 2 monthes to 7 years (average 3.5 years): tumour disappeared in 92 cases (61.4%), decreased dramatically in 20(13.4%), decreased less than fifty per cent in 19(12.6%), increased in 15(10%) and death in 4(2.6%). The operation method are introduced in detail and the questions about selecction of the nuclides, calculation of dosage, prevention and treatment of the operation complications are discussed in this paper.
