摘要
目的探讨伽玛刀治疗在脑膜血管外膜细胞瘤的综合治疗中的临床作用。方法回顾性分析1994年12月至2006年12月于本中心行伽玛刀治疗并随访的22例术后复发的患者,男13例,女9例;58个瘤灶,平均体积5.4cm^(3),平均周边剂量13.5Gy,平均中心剂量28.2Gy。结果平均随访期26个门。22例中,颅内转移7例,颅外转移3例,死亡4例,平均生存期67.7个门;58个瘤灶中,影像随访证实25个基本消失,13个明显萎缩,14个体积变化不明显,6个体积增大,肿瘤总控制率89.7%:结论伽玛刀治疗对术后残留或复发的中小型脑膜血管外膜细胞瘤安全有效,改变了以往综合治疗的策略。
Objective The aim was to assess the clinical effects of gamma knife radiosurgery(GKS)in the comprehensive treatment of meningeal hemangiopericytomas(M-HPC).Method Between December 1994 and December 2006,22 patients with 58 postoperative recurrent M-HPC underwent GKS at the Gamma Knife Center of Beijing Neurosurgical Institute(BNI).Of these 22 patients,13 patients were males and 9 patients were females.The mean volume of these tumors was 5.4 cm^(3)(ranged from 0.1 to 37.2 cm^(3)).The mean tumor margin dose was 13.5 Gy(ranged from 10.0 to 20.0 Gy).The mean tumor central dose was 28.2 Gy(ranged from 21.8 to 35.0 Gy).The mean prescription isodose line was 48.4%(ranged from 30.0%to 70.0%).Results The mean period of follow-up was 26.0 months(ranged from 5 to 90 months).Of these 22 patients,intracranial metastases developed in 7 patients,extracranial metastases in 3 patients.Four patients died.The mean life expectancy of these 22 patients was 67.7 months(ranged from 7 to 192 months).Of these 58 target tumors,radiological follow-up showed that 25 tumors(43.1%)disappeared,13 tumors(22.4%)shrinked,14 tumors(24.1%)remained stable,and 6 tumors(10.3%)enlarged.The overall tumor control rate was 89.7%.Conclusions GKS provided an effective and safe adjunct management for postoperative small to moderate sized M-HPC.Neither GKS nor WBRT seems to protect against future recurrence and metastasis.More clinical materials have demonstrated that the treatment principle should be altered with the development of GKS for recurrent M-HPC.
作者
孙时斌
刘阿力
王忠诚
罗斌
王美华
潘剑
刘鹏
SUN Shi-bin;LIU A-li;WANG Zhong-cheng;LUO Bin;WANG Mei-hua;PAN Jian;LIU Peng(Gamma Knife Center,Beijing Neurosurgical Institute,Tiantan Hospital,Capital Unitersity of Medical Sciences,Beijing 100050,China)
出处
《中华神经外科杂志》
CSCD
北大核心
2009年第1期49-52,共4页
Chinese Journal of Neurosurgery
