三叉神经鞘瘤的放射治疗临床研究  

Gamma knife radiosurgery for trigeminal schwannomas

作　　者：潘绵顺[1] 王鹏[1] 

机构地区：[1]合肥脑科医院神经外科,合肥230001

出　　处：《立体定向和功能性神经外科杂志》2006年第1期32-34,共3页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：卫生部科研基金项目(编号:WKJ-2005-3-006)

摘　　要：目的回顾性分析γ刀放射对三叉神经鞘瘤的治疗作用及治疗剂量。方法应用γ刀治疗三叉神经鞘瘤42例获得随访资料,29例经影像学检查结合临床诊断首选γ刀治疗,13例为术后复发或残留,肿瘤直径31±6.8mm,肿瘤的平均体积10.4±2.8cm3。结果42例患者平均随访时间62个月。临床症状改善情况:有11例例症状完全消失,25例患者症状改善;6例患者症状改善不明显或者症状加重;临床症状改善总有效率为85.7%。肿瘤体积控制情况:13例肿瘤基本消失,21例肿瘤明显缩小(最大径缩小1/3以上),5例肿瘤未增大(肿瘤最大径缩小少于1/3以上),3例肿瘤分别于γ刀术后5、27和63个月增大,总体肿瘤控制率为92.9%(39/42)。肿瘤平均边缘剂量13Gy,以50%～80%等剂量曲线包绕靶区。结论γ刀放射治疗对直径小于50mm三叉神经鞘瘤有良好的中长期控制作用,肿瘤控制剂量为13～14Gy。Objective To evaluate gamma knife （GK） radiosurgery in the treatment of trigeminal schwannomas. Methods From Jul 1997 to Jul 2002,42 patients with trigeminal schwannoma treated with GK radiosurgery were fully followed up and reviewed. GK was the primary treatment modality in 29 cases and followed microsurgery in 13 cases. Of the 42 tumors, the mean diameter was 31 ± 6.8 mm and the tumors volume was 10.4 ± 2.8cm^3. The mean margin tumour dose was 13Gy （range： 11-16Gy） with the isodose line between 50 % -80 %. Results 42 patients had been followed for 36 - 93 months （mean ： 62 months）. 23 had been followed more than 60 months. Clinical response： after Gamma Knife radiosurgery, neurological deficits disappeared in 12 cases, improved in 25 cases and 6 cases showed unchanged or slightly worsened symptoms. Tumor growth control：tumor disappeared after GK treatment was observed in 13 case, a marked decrease in 21 cases, a slightly decrease in 5 cases and increase in 3 cases 92.9 % （39/42）. Conclusion at 5,27 and 63 months after respectively for GK radiosurgery with the Trigeminal schwannomas of less than control dose of 13 to 14Gy. The overall local control rate was 50mm（diameter） are candidates

关 键 词：三叉神经 神经鞘瘤 放射外科 

分 类 号：R739.41[医药卫生—肿瘤]