脊椎血管瘤手术后复发放射治疗疗效观察(附6例报告)

目的 探讨脊椎血管瘤手术后复发放射治疗疗效和适宜剂量。方法 1968—1992年间共收治手术后复发的有症状的脊椎血管瘤6例，中位年龄28岁。病灶在胸椎5例，腰椎1例。4例有病灶局部疼痛合并不完全性截瘫，2例为局部疼痛合并下肢麻木无力。采用^60Co和8MV—X线照射治疗，总剂量范围30-60Gy，平均40Gy。结果 所有接受放疗的患均获得良好的远期效果，4例不完全截瘫患中3例基本恢复，1例完全恢复，另外2例原有的下肢麻木症状消失，但影像学检查均无明显改变。结论 放射治疗对手术后复发的脊椎血管瘤是安全有效的，剂量以36—40Gy为宜。但放射治疗起效比较慢，且影像学改变不明显，所以应以远期症状改善率作为评价放射治疗效果的标准。

The efficacy of radiotherapy for recurrent vertebral hemangiomas after surgery (6 cases report)

Objective To investigate the efficacy and suitable total dose of radiotherapy for recurrent vertebral hemangiomas after surgery. Methods and Materials Between 1968 and 1992, there were 6 patients (4 males, 2 fe- males) with recurrent vertehral hemangiomas after surgery. The ages ranged from 15 to 63 years with a median of 28. The lesions were in thoracic spine in 5 cases and in lumbar vertebra in 1 patient. Four of 6 patients had local pain in the spine and paraplegia, 2 cases had local pain and numbness and/or weakness in the lower extremities. All cases received radiotherapy with ~(60)Co or 8MV X-ray, five treatments per week, 2.0-2.5 Gy/per fraction. The total dose ranged from 30 to 60Gy with a median of 40. Results The long term results of radiotherapy were satisfactory in all patients. Among 4 patients with paraplegia, 3 cases achieved almost recovery and 1 complete recovery. The symptoms of numbness in the lower limbs disappeared in another 2 patients. The radiographic films and CT scans of tumors had no change after treatment. Conclusions Radiotherapy is an effective and safe modality for symptomatic recurrent vertebral hemangio- mas. The range of suitable total dose is 36 to 40 Gy. Radiotherapy showed slowly effects on vertebral hemangiomas and symptom was gradually relieved or disappeared from several moths to many years without significant radiographic chang- es. The long-term recovery rate should be regarded as a criterion for evaluation of effect of radiotherapy.