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伽玛刀结合囊内照射治疗颅咽管瘤的临床疗效分析
引用本文:于新,周东学,刘宗惠,李士月,杜吉祥,亓树彬,修波,赵全军,江荣才,李翠宁.伽玛刀结合囊内照射治疗颅咽管瘤的临床疗效分析[J].中华医学杂志,2001,81(2):86-89.
作者姓名:于新  周东学  刘宗惠  李士月  杜吉祥  亓树彬  修波  赵全军  江荣才  李翠宁
作者单位:1. 100037北京,中国人民解放军海军总医院神经外科
2. 河北省一州县人民医院
摘    要:目的 探讨和评价伽玛刀结合立体定向放射性同位素囊腔内入内放射治疗对颅咽管瘤的治疗效果。方法 对46例确诊为颅咽管瘤的患者进行伽玛刀与立体定向放射性同位素囊内置入内放射治疗。其中男24例,女22例;年龄3-60岁,平均38.6岁。大实体小囊型肿瘤13例,小实体大囊型33例,28例接受过开颅手术。大实体小囊型行囊液穿刺后伽玛刀治疗,小实体大囊型则行联合治疗,伽玛刀治疗实体部分,立体定向同位素内放射治疗囊性部分。结果 38例获6个月-2年(平均16个月)的随访,大实体小囊型的控制率为90.0%(40/46)。无严重并发症及手术死亡。结论 伽玛刀结合立体定向囊内放射治疗是治疗颅咽管瘤的一种简单、安全而且有效的方法,特别适合于手术后残留或复发不适宜手术的囊实混合性肿瘤和距视神经有一定距离的实体性颅咽管瘤。

关 键 词:颅咽管瘤  近距离放射疗法  伽玛刀  囊内照射  放射疗法
修稿时间:2000年3月21日

Combination treatment for craniopharyngiomas with stereotactic intracavitary irradiation and gamma knife surgery
X Yu,D Zhou,Z Liu.Combination treatment for craniopharyngiomas with stereotactic intracavitary irradiation and gamma knife surgery[J].National Medical Journal of China,2001,81(2):86-89.
Authors:X Yu  D Zhou  Z Liu
Institution:Neurosurgical Department of Navy General Hospital, Beijing 100037, China.
Abstract:Objective To evaluate the effectiveness of the combination treatment for craniopharygiomas with stereotactic intracavitary irradiation and gamma knife surgery. Methods Combination treatment of stereotactic instillation of radioisotopes and gamma knife surgery was performed in 46 patients with craniopharyngioma between October 1996 and June 1999. There were 24 men and 22 women, with age ranging from 3 to 60 years (average 38.6 years). There were 13 solid tumors and 33 mixed solid and cystic tumors. Twenty eight patients had undergone prior caraniotomies with total or partial resection of tumors, with or without followed external beam radiation therapy. Gamma knife surgery was done in solid tumors and the combination treatment was done in mixed tumors: the cyst being treated with stereotactic intracavitary radiation and the solid part with Gamma knife. Results Thirty eight patients (10 solid and 28 mixed) were followed up from 6 months to two years(averaged 16 months). The tumor control rate (disappeared,decreased and unchanged) was 90% in solid tumor,85.7% in mixed tumors, and 92.1% in solid segment and the total control rate was 89.5%. Conclusion The combination treatment is a simple, safe and effective method for craniopharyngiomas, especially for the recurrent mixed solid and cystic tumors. Gamma knife surgery plays an important role in the treatment of solid component of the craniopharyngiomas.
Keywords:Craniopharyngioma  Brachytherapy
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