应用γ刀治疗眼眶脑膜瘤临床观察  

Treatment of orbital meningioma with gamma knife

作　　者：唐东润[1] 徐德生[2] 宋国祥[3] 孙丰源[4] 郑立高[2] 

机构地区：[1]天津市眼眶病研究所,300211 [2]天津医科大学第二医院γ刀治疗中心,300211 [3]天津医科大学第二医院眼科,300211 [4]天津市眼科医院眼肿瘤眼眶病科,300020

出　　处：《眼科研究》2007年第3期211-214,共4页Chinese Ophthalmic Research

摘　　要：目的 观察γ刀在眼眶脑膜瘤治疗中的作用和适应证.方法 对43例经γ刀治疗的眼眶脑膜瘤患者进行定期随访,其中34例得到临床和影像学随访结果;γ刀放射治疗平均中心剂量32.22 Gy,等剂量曲线范围为79%～95%,平均随访时间30个月.结果 治疗后肿瘤缩小19例,消失2例,无变化6例,增大3例,4例未做影像学检查;肿瘤控制率为90.0%（27/30）.治疗后视力提高12例,减退4例,丧失3例,不变15例.除1例因脑血管疾病死亡外,无死亡病例.结论 γ刀治疗对眼眶脑膜瘤是一种有效的微创治疗方法,并发症少,可保留一部分视力,适用于视神经鞘脑膜瘤向视神经管内蔓延、眶内异位脑膜瘤及蝶骨嵴脑膜瘤.Objective The surgery removal of meningioma often cause loss of vision and recurrence of tumor because of its specific location in optic nerve sheath. Gamma knife has less damage to normal tissue and better effectiveness on tumor of brain. We observed the therapy effect of gamma knife on orbital meningioma. Methods Forty-three patients with orbital meningioma were treated with gamma knife, and 34 cases were followed up by telephone or letter, including 23 optic nerve sheaths meningioma,3 intra-orbital meningioma and 8 orbitocranium communication meningioma. B ultrasound, CT, MRI and color Doppler were examined during fellow-up period. The irradiation dose of gamma knife therapy ranged from 30, 0 to 45.5 Gy （ mean 32.22 Gy） ,and the isodose curves were from 79% to 95%. The average duration of follow-up was 30 months （ ranging from 6 months to 72 months）. Results After irradiation,in 30 cases with meningioma,the volume of 19 meningioma was decreased, and 2 meningioma were disappeared （ mean volume of diminution 0. 65 cm^3 ）. Six meningioma were unchanged in size and 3 were enhanced in the patients received imaging examination, showing 90. 0% （27/30） control rate for tumor growth. The vision acuity was not altered in 15 cases. Vision loss was in 3 cases,decreased in 4 cases and increased in 12 cases. One patient dead for cerebrovascular disease. No long-term complications were found during the follow-up period. Conclusion Gamma knife shows a very good effectiveness for meningioma. The indication of gamma knife therapy includes the meningioma of optic nerve sheath spreading into nerve canal or residual or recurrent orbit meningioma.

关 键 词：眼眶脑膜瘤 Γ刀 立体放射外科 放射治疗 

分 类 号：R739.7[医药卫生—肿瘤]