囊性颅咽管瘤立体定向囊腔内放疗的临床研究

目的　探讨囊性颅咽管瘤囊腔内放疗的有效性和安全性。方法　对 5 6例囊性颅咽管瘤行CT引导立体定向囊腔内放疗 ,根据个体化剂量设计分别置入 1～ 3次、2 .4～ 14 .8MBq不等胶体磷酸铬 (Cr3 2 Po4) ,并进行临床随访观察。结果　 5 6例患者术后神经功能均很快出现不同程度的改善。随访 6个月至 9年 ,49例视力、视野障碍中 ,45例获得逐渐改善 ,4例恶化 ,偏瘫 3例恢复正常 ,所有内分泌功能障碍者均获得稳定或不同程度好转 ,复查CT或MR示 :5例瘤实质增大 (9% ) ,2例新的囊腔形成 ,1例导管在脑室内囊腔略缩小 ,囊腔完全消失 2 4例 (4 3 % ) ,囊腔明显缩小 (>80 % )2 4例 (86% )。无手术死亡及严重并发症。结论　立体定向囊腔内放疗是一种治疗囊性颅咽管瘤的安全而有效方法 ,放射剂量设计的个体化是提高治疗有效率的关键。

Clinical study on stereotactic intracavitary irradiation for cystic craniopharyngioma

Objective To study the efficiency and safety of stereotactic intracavitary irradiation for cystic craniopharyngioma.Methods 56 patients with cystic craniopharyngioma were treated by CT guided stereotactic intracavitary irradiation with a colloid containing chromium phosphate with 32 P.Results The clinical symptoms were improved after the evacuation of cystic fluid in all patient.All of them were fowlloed up from 6 months to 9 years.45 of 49 cases with optic pathway impairment were gradually improved,and the others worsened.3 cases with hemiplegia recovered.Tumour cyst disappeared in 24 cases(43%),markedly decreased in 24(43%), size increased in 5(9%),new cyst formed in 2.There were no severe complications and death related to the operation.Conclusion CT guided stereotactic intracavitary irradiation is an effective and safe method for cystic craniopharyngioma.The key to the improvement of effective rate is to design irradiation dose individually.