伽玛刀立体定向放射治疗与显微外科手术治疗中小型听神经瘤的临床对比分析  

Comparisive analysis of outcomes of gamma knife stereotactic radiosurgery and microsurgery in small- and medium-sized acoustic neuroma

作　　者：曾以勒[1] 石松生[2] 

机构地区：[1]福建医科大学附属第二医院神经外科,福建泉州362000 [2]福建医科大学附属协和医院神经外科,福建福州350001

出　　处：《肿瘤》2014年第3期271-274,共4页Tumor

摘　　要：目的 :比较伽玛刀立体定向放射治疗与显微外科手术治疗中小型听神经瘤的临床疗效。方法 :回顾性收集2002—2008年共87例单侧中小型听神经瘤(肿瘤最大直径<3 cm)患者的病历资料,其中伽玛刀立体定向放射治疗组42例,显微外科手术治疗组45例。比较两组的肿瘤局部控制率、颅神经功能保留率、首次住院总费用、首次住院持续时间以及并发症情况等。结果 :两组的肿瘤局部控制率差异无统计学意义(伽玛刀立体定向放射治疗组为88.1%,显微外科手术组为97.8%;P=0.102)。伽玛刀立体定向放射治疗在保护面神经功能(分别为87.2%和66.7%,P=0.029)和听力(分别为68.2%和30.0%,P=0.013)方面均优于显微外科手术组。显微外科手术组的并发症发生率高于伽玛刀立体定向放射治疗组(分别为22.2%和7.1%)。与伽玛刀立体定向放射治疗组相比,显微外科手术组的首次住院总费用较高,首次住院持续时间较长。结论 :与显微外科手术相比,伽玛刀立体定向放射治疗对于中小型听神经瘤的治疗更具优势。Objective： To compare the efficacy and outcomes of gamma knife stereotactic radiosurgery and microsurgery in small- and medium-sized acoustic neuroma. Methods： The medical records of 87 patients with unilateral acoustic neuroma less than 3 cm were retrospectively collected. These 87 patients were divided into two groups： gamma knife stereotactic radiosurgery （GSR） group （n = 42） and microsurgery （MS） group （n = 45）. The local control rate of tumor, preservation rate of cranial nerve function, hospitalization cost in first admission, length of stay in hospital, and the complications were campared between the two groups. Results： The difference in local control rate of tumor was not significant （GRS group vs MS group： 88.1% vs 97.8%; P = 0.102）. In respect of preservation of facial nerve function and hearing, GRS was more effective than MS （87.2% vs 66.7%, P = 0.029; 68.2% vs 30.0%, P = 0.013）. The rate of complications in the MS group was much higher than that in the GRS group （22.2% vs 7.1%）. As compared with the GRS group, the hospitalization cost in first admission of the MS group was higher and the length of stay in hospital was prolonged. Conclusion： GSR has much more advantages in treatment of small- and medium-sized acoustic neuroma as compared with MS.

关 键 词：听神经瘤 立体定向放射治疗 伽玛刀 显微外科 

分 类 号：R739.41[医药卫生—肿瘤]