颅内非听神经性神经鞘瘤的放射外科治疗临床研究  

Gamma knife radiosurgery for trigeminal schwannomas

作　　者：王鹏[1] 潘绵顺[2] 朱世友[2] 许玉华[2] 赵磊 

机构地区：[1]天津医科大学肿瘤医院,天津在读博士300060 [2]合肥脑科医院 [3]芜湖市计划生育药具管理站

出　　处：《立体定向和功能性神经外科杂志》2007年第6期354-357,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：卫生部科技资助基金(编号:WKJ2005-03-006)

摘　　要：目的回顾性分析伽玛刀放射外科对非听神经性神经鞘瘤的疗效及治疗剂量。方法应用γ刀治疗非听神经神经鞘瘤,43例获得完全随访资料,包括24例三叉神经鞘瘤和19例颈静脉孔神经鞘瘤。以50%～80%等剂量曲线包绕靶区,肿瘤中位剂量分别为13Gy(三叉神经鞘瘤)和15Gy(颈静脉孔神经鞘瘤)。结果43例患者平均随访时间62个月。本组随访影像提示24例三叉神经鞘瘤患者伽玛刀治疗后肿瘤基本消失的4例(16.6%),肿瘤体积明显萎缩的12例(50.0%),肿瘤体积没有明显改变的6例(25%),肿瘤体积增大的2例(8.3%),肿瘤总控制率91.7%(22/24)。19例颈神经孔神经鞘瘤患者伽玛刀治疗后肿瘤基本消失的3例(15.8%),肿瘤体积明显萎缩的9例(47.4%),肿瘤体积没有明显改变的6例(31.6%),肿瘤体积增大的1例(5.3%),肿瘤总控制率94.7%。本组患者肿瘤局部控制率为93%(41/44)。临床症状改善总有效率为88.4%(38/43)。结论γ刀放射外科对非听神经性神经鞘瘤有良好的中长期控制作用,毒副作用较少。Objective To evaluate the outcomes of gamma knife （GK） radiosurgery of non-vestibular schwannomas. Methods From Nov 1997 to Jul 2002,43 patients with nonvestibular schwannoma including 24 trigeminal schwannomas and 19 jugular foramen schwannomas treated with GK radiosurgery were fully followed up and reviewed. The mean margin tumour dose was 13 Gy and 15 Gy for trigeminal schwannomas and jugular foramen schwannomas respectively with the isodose line between 50%-80%. Results 43 patients had been followed for 36-93 months （mean.62 months）. 23 had been followed more than 60 months. For patients of trigeminal schwannomas, lesions almost disappeared in 4 cases, shrunk greatly in 12 case, almost no changes in 6 cases, and enlarged in 2 cases, and for patients of jugular foramen schwannomas, lesions almost disappeared in 3 cases, shrunk greatly in 9 case, almost no changes in 6 cases, and enlarged in 1 cases. For all the patients, the overall local control rate is 94. 7% and the overall symptoms relief is 88. 4%. Conclusion Although the reported number of patients having radiosurgery for nonvestibular schwannomas is limited, the high tumor control rates demonstrated after vestibular schwannoma radiosurgery should apply to these rare tumors. Compared to historical controls treated with surgical resection, radiosurgery appears to have less treatment-associated morbidity for nonvestibular schwannomas, especially for schwannomas involving the lower cranial nerves.

关 键 词：三叉神经鞘瘤 颈静脉孔神经鞘瘤 放射外科 

分 类 号：R739.41[医药卫生—肿瘤]