Leksell-C型伽玛刀治疗听神经瘤的长期疗效分析  

Long-term outcomes of vestibular schwannomas following Leksell-C Gamma Knife radiosurgery treatment

作　　者：陈状[1] 梁军潮[1] 王伟民[1] 吴鸿勋[1] 刘德平[1] 张聿浩[1] 宁琼芳[1] 

机构地区：[1]中国人民解放军广州军区广州总医院神经外科,广东广州510010

出　　处：《中国微侵袭神经外科杂志》2009年第8期350-352,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的分析Leksell-C型伽玛刀治疗听神经的长期疗效。方法回顾性分析长期随访的64例听神经瘤的临床资料。其中曾行开颅手术17例,面神经功能正常53例,具备有用听力41例。肿瘤体积0.2～33.9cm3,平均7.7cm3;治疗周边剂量11.0～14.0Gy,平均12.7Gy;等剂量曲线40%～60%,靶点数2～15个,平均6个。结果随访46～81个月,平均62.2个月。肿瘤缩小52例,稳定9例;肿瘤增大3例,其中2例在3年后再次行伽玛刀治疗,随访显示肿瘤缩小,另1例在治疗后2年行开颅手术。发生面神经功能损伤2例,保留有用听力29例。发生三叉神经功能障碍8例(其中一过性损伤6例,损伤率为3.1%)。结论Leksell-C型伽玛刀放射外科治疗听神经瘤具有良好的肿瘤控制率和有用听力保留率,神经功能损伤发生率低,值得临床推广应用。Objective To evaluate the long-term efficacy of Leksell-C Gamma Knife radiosurgery （GKS） for patients with vestibular schwannomas （VS）. Methods Clinical data of 64 patients with VS were analyzed retrospectively, Seventeen cases ever received digging skull operation previously; 53 cases had normal facial nerve fimction; 41 patients had serviceable hearing. The mean tumor size was 7.7cm^3 （ranging from 0.2 to 33.9 cm^3）. A mean peripheral dose prescription of 12.7 Gy was used （ranging from 11.0-14.0 Gy）. The isodose curve varied between 40% and 60%. Two to fifteen targeting points were determined （mean 6）. Results The follow-up period ranged from 46-81 （mean 62.2） months. Tumor shrinkage was observed in 52 patients. Tumor size was stable in 9 cases. Tumor enlargement was observed in 3 patients, among these, 2 underwent another GKS after 3 years and the follow-up visit showed tumor shrinkage; 1 underwent surgical removal after 2 years. Facial palsy was reported in 2 cases. Serviceable hearing was preserved in 29 patients. Eight patients experienced trigeminal dysfunction, including transient dysfunction in 6 cases （3.1%）. Conclusion Leksell-C GKS shows satisfactory tumor size control effects and excellent serviceable hearing preservation efficacy in patients with VS. The risk of GKS treatment-related cranial nerve toxicities is low. Leksell-C GKS deserves clinical generalization.

关 键 词：神经瘤 听 放射外科手术 治疗效果 

分 类 号：R739.4[医药卫生—肿瘤]