伽玛刀治疗松果体区肿瘤

目的探讨伽玛刀治疗松果体区肿瘤的具体方法,进一步提高其疗效.方法使用伽玛刀治疗松果体区肿瘤94例;周边剂量9.0～18.0 Gy(平均14.2 Gy);中心剂量16.0～48.5 Gy(平均35.4 Gy);周边剂量曲线30.0%～90.0%(平均43.5%);射点数1～10个(平均4.3个).随访6个月～8年(平均25.5个月).结果病灶消失者46例,其中16例为多发病灶;病灶明显缩小者31例,缩小11例,无明显变化3例.3例肿瘤体积增大并伴有放射性脑水肿,6例行2,3次伽玛刀治疗.结论定位诊断明确的松果体区占位病变,首选伽玛刀治疗是一种安全有效的方法,对有明显梗阻性脑积水患者,可先行脑室-腹腔分流术后再行伽玛刀治疗.

Gamma knife radiosurgery for pineal region tumors

Objective: To evaluate the efficacy of Gamma knife radiosurgery in the management of patients with pineal region tumors. Methods: 94 cases of pineal region tumors were treated with Gamma knife radiosurgery. The margin dose was 14.2 Gy (rang 9~18 Gy) at the 43.5% (rang 30.0%~90.0%) isodose line. The center dose was 35.5 Gy (rang 16~48.5 Gy). All cases were followed up 6 months to 8 years. Results: Tumor disappeared in 46 cases, including 16 cases mutipli lesions in the brain,obviously reduced in 31 cases, no change in 3 cases. Complications included radiation-induced edema and enlargement in 3 cases. Conclusion: Gamma knife radiosurgery is a safe and effective method for the treatment of patients with pineal region tumors. A V-P shunt should be considered before radiosurgery for patients with sever hydrocephalus.