累及眶内肿瘤的伽玛刀治疗

目的 总结累及眶内肿瘤的伽玛刀治疗效果.方法 共治疗累及眶内的肿瘤患者35例,随访25例(脑膜瘤16例,脑膜血管外皮细胞瘤3例,神经鞘瘤2例,腺样囊性癌2例,转移癌1例,血管纤维瘤1例),采取1.5T PHILIPS或3.0T GE磁共振2 mm薄层扫描定位,Kula或GammaPlan剂量计划系统.肿瘤平均体积2.91 cm3(0.17～19.50 cm3),平均周边剂量12.4 Gy(8～15 Gy),中心剂量26.7 Gy(16～32 Gy).结果 本组随访期为1-62个月,平均30.4个月,23例控制满意,总体控制率为92%;6例(24%)症状减轻,13例(52%)症状无改变,5例(20%)出现了一过性的新发或原有症状加重;2例肿瘤增大,其中1例因突眼加重而行手术治疗.结论 对于累及眶内的较小病变、或经手术治疗后残留、复发等不宜手术治疗的病例,伽玛刀治疗可作为综合治疗的重要手段.

Gamma knife for tumors involving orbit

Objective To investigate the outcomes of gamma knife treatment of patients with tumors involving orbit. Methods From 1995 to 2008, 35 patients with tumors involving orbit were treated by Leksell Gamma Knife in our center. 25 patients ( 16 meningiomas, 3 meningeal hemangiopericytomas, 2 schwannomas, 2 adenoid cystic carcinomas of the lacrimal gland, 1 metastatic tumor and 1 angiofibroma)were followed - up. MRI ( 1.5T PHILIPS or 3. 0T GE ) with 2 - mm thick slice was performed to acquire images for targeting tumors and Kula or GammaPlan was used. The mean tumor volume was 2.91 cm3 (0.17～ 19.50 cm3 ). The median marginal dose was 12. 4 Gy (8 ～ 15 Gy) and the median center dose was 26. 7 Gy ( 16 ～ 32 Gy) . Result After a mean follow - up of 30. 4 months ( 1 - 62 months) for 25 patients,tumor control was confirmed in 23(92％ ) patients. 6(24％ ) patients got symptoms relieved and 13(52％)stable. Transient symptoms development was observed in 5 ( 20％ ) patients. Of the 2 patients with tumor progression, 1 patient had to undergo another operation due to developed exophthalmos. Conclusions Gamma knife may be an effective treatment option for small or residual tumors involving orbit.