瘤腔内间质放疗治疗囊性颅咽管瘤的疗效观察(附75例报告)

目的探讨和观察囊性颅咽管瘤的最佳治疗方法及其疗效。方法对75例囊性或囊性为主的颅咽管瘤采用CT立体定向瘤腔内注入放射性胶体磷酸铬的方法进行治疗。结果除6例失去随访、3例肿瘤实质增大复发外,其余66例经随访的CT或MRI显示瘤腔消失、症状持续改善,47例（71.2%）由治疗前不同程度视力减退恢复至正常,2例女性恢复月经,2例身长明显增高,无术后内分泌紊乱和手术死亡率。结论本方法与开颅切除肿瘤术相比较,具有侵袭性小、无明显并发症、住院时间短、疗效显著的优点,本方法应作为治疗囊性颅咽管瘤的首选方法,对实质为主的颅咽管瘤仍应采用开颅手术切除的方法。

Effect of intracavitary irradiation with CT-guided stereotactic method for the treatment of cystic craniopharyngioma

Objective To seek the best treatment of cystic craniopharyngioma and observe its effect.Methods 75 patients with cystic or predominantly cystic craniopharyngioma were selected.Colloidal chromic phosphate was injected intracystically by a computed tomography-guided stereotactic method.Results Except that six patients were lost in follow-up and three patients had the solid tumor relapsed,66 patients showed cyst disappearance with the follow-up by CT or MRI examination and persistent improvement of symptoms.After treatment,visual deficits of various degrees had recovered to normal level 47 patients(71.2%).Menses recovered in two female patients.The statures were heighten obviously in two patients.There were no endocrine disturbance and death postoperatively.Conclusions Compared with the method of tumor removal via craniotomy,the intracavitary irradiation method had the advantages of less invasion,no obvious complications,short hospitalized time and marked values of treatment.This method should be the first choice to treat the cystic craniopharyngioma whereas craniotomy could be adopted to the solid craniopharyngioma.