海绵窦海绵状血管瘤的临床特点及伽玛刀治疗效果  

Clinical characteristics and gamma knife surgery of cavernous sinus hemangioma

作　　者：孙君昭 张剑宁 于新 亓树彬 杜亚楠 倪伟刚 胡勇 田增民 

机构地区：[1]海军总医院全军神经外科研究所,北京100048

出　　处：《中华神经医学杂志》2013年第9期905-908,共4页Chinese Journal of Neuromedicine

摘　　要：目的回顾性分析评价伽玛刀对海绵窦海绵状血管瘤的治疗作用。方法海军总医院全军神经外科研究所自1997年11月至2011年6月应用伽玛刀治疗海绵窦海绵状血管瘤33例，其中10例为术后残留，23例经影像诊断。肿瘤平均直径29ram（12-65mm）。伽玛刀治疗的平均周边剂量12．5Gy（9-16Gy），平均等剂量曲线47．7％（40％～50％）。结果32例患者获随访，平均随访时间46个月（6～135个月）。30例（93．8％）治疗后症状明显好转或消失，2例f6．2％）同治疗前。本组治疗后无其他颅神经功能受损症状出现；肿瘤基本消失9例（28．1％），肿瘤体积明显萎缩21例（65．6％），体积较伽玛刀治疗前无明显改变2例（6．7％），肿瘤总控制率100％。2例患者因治疗前肿瘤体积巨大行分次伽玛刀治疗。结论伽玛刀治疗海绵窦海绵状血管瘤安全有效．并可有效改善其临床症状。Objective To evaluate the role of Gamma knife surgery （GKS） in the treatment of cavernous sinus hemangiomas. Methods Thirty-three patients underwent GKS for cavernous sinus hemangioma at our hospital fi＇om November 1997 to June 2011 were chosen in our study; 10 had prior tumor resection and 23 underwent radiosurgery on the basis of imaging diagnosis only. The mean diameter of 33 tumors was 29 mm. （ranged 12-65 mm）. The mean marginal dose was 12.5 Gy （ranged 9-16 Gy）, and the mean prescription isodose configuration was 47.7% （ranged 40%-50%）. Results Follow up in the 32 patients was performed for 6-135 months （mean 46 months）. Neurological symptoms or signs improved or dismissed in 30 patients （93.8 %） and a stable lesion was noted in 2 patients （6.2%）. No other cranial nerve dysfunction symptoms appeared. On imaging, the hemangiomas almost disappeared in 9 patients （28.1%）, shrank in 21 （65.6%） and remained stable in 2 patients （6.7%）. Tumor growth control was achieved in all patients （100%）. Two patients because of the big tumor volume received fractionated gamma knife treatment. Conclusion The use of GKS in treating cavernous sinus hemangiomas is safe and effective, and can achieve functional improvement.

关 键 词：海绵窦 血管瘤 伽玛刀 

分 类 号：R743.4[医药卫生—神经病学与精神病学]