伽玛刀治疗原发性视神经鞘脑膜瘤的视力控制情况分析

目的 探讨影响伽玛刀治疗原发性视神经鞘脑膜瘤(PONSM)术后视力控制效果的相关因素。方法 收集本院伽玛刀治疗中心收治的26例PONSM患者,2例经病理证实,24例经MRI表现结合临床特征诊断。所有患者术后均定期复诊,通过分析肿瘤控制率及视力控制率评定疗效。评估伽玛刀治疗参数、患者不同临床特征及术前MRI表现对视力预后情况是否产生影响。结果 经过6~62个月随访,视力控制率为65.4%,肿瘤控制率为96.2%。发病年龄(P=0.034)、起病急缓(P=0.014)及术前肿瘤形态(P=0.034)与伽玛刀术后视力控制有显著关系。结论 伽玛刀治疗PONSM疗效较好,其术后视力控制效果主要取决于患者的发病年龄、起病急缓,并与伽玛刀术后出现的放射性损伤程度有关。

Effect of gamma knife surgery for primary orbital optic nerve sheath meningioma upon visual control and influencing factors thereof

Objective To investigate the effect of gamma knife surgery (GKS) in treatment of primary orbital optic nerve sheath meningioma (PONSM) upon visual control and to explore the factors influencing the visual acuity changes after GKS. Methods Totally 26 PONSM patients, 3 males and 23 females, aged 35.5 (4-66) years old, 2 pathologically confirmed and 24 confirmed by MRI, underwent GKS, and were followed up for 20.2 months (6-62 months). The efficacy of GKS was evaluated by the change of tumor volume and visual acuity. The relations between the change of visual acuity and different clinical features were analyzed. Results The vision control rate was 65.4%, and the tumor control rate was 96.2%. The onset age, onset speed, and preoperative shape of PONSM were significantly correlated with the visual change after GKS (P=0.034, 0.014, and 0.034 respectively). Conclusions The efficacy of GKS in patients with PONSM is fine, which depends on the onset age, onset speed,as well as the degree of radiation-induced side effect after GKS.