伽玛刀在海绵窦脑膜瘤治疗中的价值  

Gamma Knife Radiosurgery for Meningiomas in Cavernous Sinuses

作　　者：万衡[1] 于文生[2] 袁树斌 李宗平[4] 王伟[4] 

机构地区：[1]四川大学华西第四医院神经科,四川成都610041 [2]内蒙古医学院第二附属医院神经外科,内蒙古呼和浩特010030 [3]成都空军医院伽玛刀治疗中心,四川成都610021 [4]四川大学华西医院神经外科伽玛刀治疗中心,四川成都610041

出　　处：《中国临床神经外科杂志》2007年第10期592-594,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨伽玛刀在海绵窦脑膜瘤治疗中的效果。方法1997年至2004年间93例海绵窦脑膜瘤患者接受了伽玛刀治疗。其中57例有开颅手术史,36例为初发。治疗前肿瘤容积为1.3～128.6cm3(平均24.18cm3),采用40%～60%(平均48%)的等剂量曲线,边缘剂量为7～18Gy(平均10.9Gy),中心剂量为16～40Gy(平均22.5Gy),等中心点为2～21个(平均8.7个)。结果本组93例患者获得36～78个月(平均43.7个月)的影像学随访,其中肿瘤消失12例(12.9%),肿瘤缩小37例(39.8%),肿瘤无明显变化26例(28.0%),肿瘤增大18例(19.3%),肿瘤总控制率为80.6%。结论对于累及海绵窦区的脑膜瘤,伽玛刀治疗手术风险小,并发症少,长期随访效果较好。Objective To study the curative effect of gamma knife radiosurgery on cavernous sinus meningiomas. Methods Of 93 patients with cavernous sinus meningiomas,who underwent gamma knife radiosurgery in our center from 1997 to 2004,57 patients suffered from recurrent meningiomas after the surgery and 36 from primary meningiomas. The tumor volume ranged from 1.3 to 128.6 cm^3 （mean,24.18 cm^3） before the radiosurgery. The isodose line curve ranged from 40% to 60% （mean,48%）. The marginal dose ranged from 7 to 18 Gy （mean,10.9 Gy）,and the centre dose ranged from 16 to 40 Gy （mean,22.5 Gy）. Results Ninety-three patients were followed up for 36～78 months （mean,43.7 month） by imaging examination. The tumors disappeared in 12 patients （12.9%）,the tumors shrank in 37 patients （39.8%）,the tumors were unchanged in 26 patients （28.0%）,and the tumors became bigger in 18 patients （19.4%）. The total tumor growth control rate was 80.6%. Conclusion Gamma knife radiosurgery for meningiomas invading cavernous sinuses is safe and reliable. Its long-term curative effect on the meningiomas in cavernous sinuses is good.

关 键 词：海绵窦 伽玛刀 脑膜瘤 

分 类 号：R739.45[医药卫生—肿瘤] R815.6[医药卫生—临床医学]