摘要
目的 总结对脑胶质瘤患者X刀治疗的临床效果。方法 我院用X刀治疗脑胶质瘤 5 0例 ,其中分次X刀治疗 4例。星形细胞瘤 48例 ,髓母细胞瘤 2例。X刀周边剂量 14.14～ 2 8.5 0Gy ,平均 (2 1.17± 3.79)Gy ,一般以 70 %～ 90 %等剂量线覆盖肿瘤边缘。 43例经 6～ 5 4个月随访。 结果 影像学检查发现肿瘤消失 8例 ,缩小 11例 ,大小不变 13例 ,增大 11例。肿瘤坏死 2 1例 ,囊性变 8例 ,环状强化 9例 ,肿瘤暂时性反应性肿大6例 ,脑水肿 10例 ,脑坏死 2例。结论 对手术难以切除、体积小的胶质瘤X刀治疗安全有效 ,X刀术后脑水肿较常见 ,分次X刀治疗有可能降低其发生率 。
ObjectiveThe clinical effectiveness of stereotatic radiosurgery for glioma was analyzed retrospective ly. Methods Forty eight patients with astrocytoma and 2 patients with recurrent medulloblastoma were treated by Single fraction radiosurgery( n =46) or fractionated stereotactic radiotherapy( n =4) employing a modified linear accelerator. The mean dosage applied was (21.17±3.79) Gy (range 14.14 to 28.50 Gy) to the 70%～90% isodose covering the edge of the tumour. The follow up period after Stereotactic irradiation in 43 cases was 15.35 monthes (range 6～54 monthes). Results MRI and/or CT images showed disappearance of the tumor in 8, decease in size in 11, unchanged in 13 and increase in size in 11 cases. Among these, necrosis of the tumor was found in 21 cases, cystic change in 8, circumscribed enhancement in 9, transient reactive swelling in 6, brain edema in 10 and brain necrosis in 2. Conclusions Single fraction radiosurgery and fractionated radiosurgery are safe and effective treatment modalities for unresectable small gliomas. The brain edema is a common complication, which may by lessened by fractionated radiosurgery. The transient swelling of the tumor and brain necrosis should be distinguished from tumor progression.(Shanghai Med J, 2000,23∶324 327)
出处
《上海医学》
CAS
CSCD
北大核心
2000年第6期324-327,共4页
Shanghai Medical Journal
