摘要
目的 总结伽玛 (γ)刀放射外科治疗眶内肿瘤的适应症、疗效和并发症。方法 本组 32例 ,其中 2 0例首选γ刀治疗 ,12例为手术后残留或复发瘤的治疗 ;其中神经鞘瘤 6例 ,脑膜瘤 16例 ,视神经胶质瘤 7例 ,视网膜母细胞瘤1例 ,静脉血管畸形 1例 ,脉络膜黑色素瘤 1例 ;肿瘤最大直径 0 .7～ 4 .0cm ,平均为 2 .0 8cm ;采用Leksell立体定位系统、MRI或CT影像定位 ,GammaPlan(3.0 1- 5 .2 0 )设定治疗计划 ,用Leksell2 30 0 4B型γ刀治疗。结果 全部病例随访3～ 5 9个月 ,平均 2 7.5个月 ,其中症状好转 18例 (5 6 .2 5 % ) ,无变化 10例 (31.2 5 % ) ,恶化 4例 (12 .5 0 % ) ,总有效率87.5 0 % ;影像学显示 ,肿瘤消失 2例 (6 .2 5 % ) ,缩小 17例 (5 1.13% ) ,无变化 9例 (2 8.13% ) ,增大 4例 (12 .5 0 % ) ;治疗后不良反应多在 3个月左右出现 ,主要表现为球结膜的充血水肿、眼睑水肿、眼部疼痛 ,可持续 3～ 6个月 ,经对症治疗后缓解。结论 γ刀放射外科是一种无创性、安全有效治疗眼眶内肿瘤的方法 ,既可以作为眼眶内肿瘤的首选治疗 ,也可作为手术后残余或复发肿瘤的治疗 。
Objective To study the indication, therapeutic effect and complications of gamma knife radiosurgery in intra-orbital tumors. Methods Thirty-two patients with intra-orbital tumor (10 male, 12 female), mean age of 34.8 yr (25～18 yr) were treated with γ-knife. Of these patients 20 cases were initial treated, 12 cases were treated for post-operative residue or recurrent mass. Their tumors were neurilemmoma (n=6), meningioma (n=16), optic glioma (n=7), retinlblastoma(n=1), venous deformity (n=1), and choroidal melanoma (n=1). Maximal diameter of tumors were varied from 0.7～4 cm(average 2.08 cm). All the patients had received radiosurgery with γ-knife(Leksell 23004 model B). Results All the patients were followed up 3～5 months (mean 27.5 months) post operatively. Symptoms improvement (n=18), no change (n=10) and deterioration(n=4) were found during following up period. Based on follow up imaging studies, tumors disappeared in 2 cases (6.25 %), signs decreased in 17 cases (51.13 %), no change in 9 cases (28.13 %), and tumor enlarged in 4 cases (12.5 %), the tumor control rate was 87.5 %. Conclusion Gamma knife radiosurgery is a safe and effective non-invasive approach in treatment of intra-orbital tumor. It is the first choice treatment in intra-orbital tumors as well as the treatment for post-operative residue or recurrent mass.
出处
《生物医学工程与临床》
CAS
2003年第1期22-24,共3页
Biomedical Engineering and Clinical Medicine
