伽玛刀剂量分割治疗胶质瘤的初步研究  

Preliminary study of split-dose fractionated Gamma Knife treatment for glioma

作　　者：胡泽勇[1] 夏廷毅[1] 周文静[1] 匡山[1] 王丽丽[1] 刘晓丽[1] 孙宗权[1] 王莹[1] 吕聪玲[1] 

机构地区：[1]空军总医院伽玛刀中心,北京100036

出　　处：《空军总医院学报》2005年第1期7-9,共3页Journal of General Hospital of Air Force,PLA

摘　　要：目的探讨伽玛刀剂量分割治疗脑深部较大胶质瘤的临床疗效及反应。方法OUR-旋转式伽玛刀剂量分割治疗脑深部较大(d>3cm)胶质瘤64例,均安装立体定位架可重复安装配件,每天治疗一次,连续进行2～5d,每次周边剂量4.5～10Gy,每次治疗结束时摘除定位架,下次治疗前重复原位安装。结果随访6～24个月,随访的57例中51例在2个月内缓解症状,影像复查的31例中25例肿瘤控制增长。但在随访期内临床症状复发14例,影像肿瘤复发4例。57例中治疗无效、病情加重、死亡6例。结论对于脑深部较大胶质瘤伽玛刀剂量分割治疗疗效明显,可缓解症状、提高生活质量,有望取代手术治疗成为首选;为防止肿瘤复发,应结合外放疗和化疗,必要时手术。Objective To explore the clinical effect and reaction of split-dose fractionated gamma knife treatment for deep seated big glioma. Methods Sixty four patients with deep seated big(d>3 cm) glioma were treated with split-dose fractionated OUR-rotating gamma knife. The stereotactic frames were fixed on head by four special designed accessory, and it can be removed from the head every day and put on at the same position next day. The treatments were given once a day for 2-5 days. And 4. 5-10 Gy of marginal dose was given every time. Results Fifty seven cases who had been followed up clinically for 6 -24 months, and clinical symptoms were improved in 51 two months post-treatment. Thirty one cases followed up by CT/MRI, and tumor control had been found in 25 cases. Clinical symptoms reappear in 14 cases and tumor recurrent in 4. The treatments were not effective in 6 cases died of deterioration. Conclusion For the deep seated big glioma the split-dose fractionated gamma knife treatment is effective. It can improve patient's symptom and life quality. It may substitute for the operation being the first selected treatment. It must combine with radiotherapy, chemotherapy and operation necessarily to prevent tumor recurrent.

关 键 词：放射外科学 Γ射线 神经胶质瘤 

分 类 号：R61[医药卫生—外科学] R181.81[医药卫生—临床医学]