囊性胶质瘤立体定向活检并内放疗联合γ-刀治疗  

Stereotactic Biopsy and Intracystic Radiotherapy and Gamma Knife Radiosurgery for Cystic Glioma

作　　者：刘琨[1] 陈成雨[1] 王国栋[2] 吴洪喜[2] 刘宜东[1] 聂斐[1] 

机构地区：[1]安康医院神经外科γ-刀中心,山东济宁272051 [2]山东省立医院神经外科,山东济南250021

出　　处：《中国临床神经外科杂志》2009年第4期205-207,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨立体定向穿刺活检加内放疗联合γ-刀治疗囊性胶质瘤的有效性和安全性。方法对24例脑深部及功能区囊性脑胶质瘤行CT导向立体定向穿刺活检,抽吸囊液并置入同位素32P内放疗后再对胶质瘤实体部分(包括囊壁)行γ-刀治疗,其中13例置入Ommaya管。结果术后24例临床症状均有好转或改善。术后2～3个月行影像学复查,显效17例,有效5例,无效1例,恶化1例,有效率为91.7%(22/24)。术后随访6～36个月,术后6、12、24、36个月生存率分别为95.8%(23/24)、83.3%(20/24)、63.2%(12/19)、46.2%(6/13)。无手术严重并发症发生。结论利用立体定向术加内放疗联合γ-刀治疗脑深部及功能区囊性胶质瘤,具有微创、安全、并发症少、有明显的近期效果和有效的肿瘤控制率等优点。Objective To explore the stereotactic biopsy of cystic gliomas, the curative effects of intracystic radiotherapy combined with gamma knife surgery on them, and their safety. Methods The clinical data of 24 patients with cystic gliomas, who underwent stereotactic biopsy, intraeystic radiotherapy with ^32p and then gamma knife radiosurgery, were analyzed retrospectively. The gamma knife radiosurgery was directed against the solid part of the cystic gliomas. Ommaya reservoirs were placed under the scalps in 13 patients. Results All the patients were improved in the clinical symptoms after the treatment. The imaging examination from 2 to 3 months after the treatment showed that the tumors decreased in volume by more than 50% in 17 cases, and b; from 25% to 50% in 5, and the volume of the tumor was insignificantly unchanged in 1 and enhanced in 1. During following up from 6 to 36 months （mean, 23.5 month）, The survival rates in 0.5, 1, 2 and 3 years were 95.8% （23/24）, 83.3% （20/24）, 63.2%（12/19） and 46.2%（6/13） respectively. No severe postoperative complication occurred in all the patients. Conclusions The stereotactie biopsy and intracystic radiotherapy combined with Gamma knife radiosurgery are a safe and effective method to treat cystic gliomas.

关 键 词：囊性胶质瘤 立体定向技术 穿刺活检 Γ-刀治疗 

分 类 号：R739.41[医药卫生—肿瘤] R815.6[医药卫生—临床医学]