伽玛刀治疗良性颅底脑膜瘤  

Gamma knife radiosurgery in the management of benign skull base meningiomas

作　　者：潘绵顺[1] 王鹏[1] 郭裕天[1] 葛锐[2] 丁同爱 胡咏梅[2] 

机构地区：[1]合肥脑科医院伽玛刀中心,230022 [2]合肥脑科医院MRI室,230022

出　　处：《立体定向和功能性神经外科杂志》2006年第4期217-220,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：卫生部科研基金项目(编号:WKJ2005-3-006)

摘　　要：目的 探讨伽玛刀放射外科治疗良性颅底脑膜瘤中长期疗效和毒性。方法 选取了1997～2002年治疗的颅底脑膜瘤患者196例，肿瘤体积平均6．2±4．9cm^3，给予中心剂量平均27．9±5．9Gy，周边剂量平均12．4±1．6Gy。随访根据治疗前后的影像表现和行为评分进行评估。结果 平均随访期为53．4±18．2个月（36～96个月），有完整随访资料患者178例。肿瘤的控制率为93．3％；临床表现满意度（好转和稳定）92．7％，神经症状总改善率为93．8％，并发症少且轻微。结论 伽玛刀可作为颅底较大脑膜瘤开颅术后的辅助治疗，也可作为较小肿瘤或对手术禁忌患者的首选性治疗；对长期控制肿瘤复发，保证患者良好的生存质量起重要的作用。Objective To evaluate the middle to long term outcome oi clinical efficacy and toxicity of gamma knife radiosurgery for skull base meningiomas. Methods From 1997 to 2002,a total of 196 patients received gamma knife radiosurgery for skull base meningiomas. Tumour vol- umes ranged from 0. 42 to 31.4cm^3 （mean 6.2～4. 9cm^3 ）, and doses of 7 ～18Gy（mean 12. 44±1.6Gy） were given to the turnout border at prescribed isodose curves（range 40 %~80%）. Radio- logical changes and clinical outcome were evaluated. Results 178 patients were followed completely. The overall tumour growth control rate is 93. 3%, clinical symptoms improvement is 92. 7%（stable or relief） and neurological improvement rate is 93. 8%. The complication rate is mild and tolerable. Conclusion Gamma knife radiosurgery may be a primary choice for patients with small tumours or medicall inoperablly and a postoperative choice for patients after microsurgery. Gamma knife play an important role in controlling tumor recurrence and satisfactory quality of life with mild complications.

关 键 词：颅底 脑膜瘤 伽玛刀 

分 类 号：R739.45[医药卫生—肿瘤]