伽玛刀治疗眼眶及眶颅沟通脑膜瘤中长期疗效分析与比较  

A comparative study on medium-to-long term outcomes of gamma knife radiosurgery for orbital and cranio-orbital meningioma

作　　者：宗永青[1] 徐德生[1] 刘晓民[1] 刘东[1] 李彦和[1] 张宜培[1] 

机构地区：[1]天津医科大学第二医院神经外科伽玛刀治疗中心,天津300211

出　　处：《国际神经病学神经外科学杂志》2012年第6期507-510,共4页Journal of International Neurology and Neurosurgery

摘　　要：目的探究伽玛刀(γ-刀)治疗眼眶及眶颅沟通脑膜瘤的中长期疗效及差异。方法 54例眼眶内及眶颅沟通脑膜瘤患者接受γ-刀治疗,其中眼眶内脑膜瘤32例,眶颅沟通脑膜瘤22例,肿瘤中位容积8.29 cm3(0.22～32.6 cm3),肿瘤边缘平均剂量4.2 Gy(10.0～17.0 Gy),40%～55%等剂量线。结果随访5～187个月,平均57个月,治疗后患者视力提高6例,维持不变31例,下降12例,失明5例;影像学显示肿瘤消失3例,缩小26例,无变化17例,增大8例,肿瘤总体控制率达85.2%,其中眶内脑膜瘤控制率90.6%,眶颅沟通脑膜瘤控制率77.3%。伽玛刀治疗后主要不良反应为眼部疼痛、眼睑肿胀、球结膜充血水肿等。结论伽玛刀治疗眼眶及眶颅沟通脑膜瘤具有长期控制肿瘤生长,可保留多数患者视力,并发症少等优点;眼眶内脑膜瘤在肿瘤控制及视力预后均好于眶颅沟通脑膜瘤。Objective To evaluate and compare the medium-to-long term outcomes of gamma knife stereotactic radiosurgery for orbital and cranio-orbital meningioma.Methods The authors performed a retrospective study on 54 patients who received gamma knife stereotactic radiosurgery for orbital（32） or cranio-orbital（22） meningioma.The median tumor volume was 8.29 cm3（0.22~32.6 cm3）.Patients were treated with a mean tumor marginal dose of 4.2 Gy（10.0~17.0 Gy） at the 40-55% isodose line.The average follow-up period was 57 months（5~187 months）.Results The overall tumor control rate was 85.2%（90.6% for orbital meningioma and 77.3% for cranio-orbital meningioma,respectively）.Of those tumors,3 disappeared radiographically,26 decreased in size,17 remained stable,8 increased in size.Visual function as of the last follow-up was improved in 6,unchanged in 31,deteriorated in 12 and completely lost in 5 cases.The main adverse effects after treatment were ophthalmalgia,palpebral edema,and conjunctival congestion,etc.Conclusions Gamma knife radiosurgery can achieve long-term tumor control for those two types of meningioma with relatively fewer side effects.Vision can be preserved in most cases.Orbital meningioma predicts better prognosis than cranio-orbital meningioma.

关 键 词：眼眶肿瘤 眶颅沟通肿瘤 脑膜瘤 伽玛刀 放射外科 

分 类 号：R739.7[医药卫生—肿瘤]