伽玛刀治疗5 508例颅内病变回顾

目的总结10年来应用伽玛刀(γ-刀)治疗颅内病变5 508例的经验体会.方法对5 508例中常见的垂体瘤1387例治疗,统计158例巨大垂体瘤治疗效果与方法;听神经瘤312例中50例复发治疗随访结果;脑膜瘤460例中进行随访;脑动静脉畸形527例中统计130例随访结果;740例脑转移瘤治疗中556例随访结果进行总结.结果垂体瘤γ-刀的治疗总有效率为98.1%,听神经瘤有效率为41.6%,脑动静脉畸形有效率为83.3%,脑转移瘤有效率为81.8%.结论γ-刀已成为神经外科领域重要的治疗手段之一,但应进一步根据有关生物学试验及临床病人个体反应来阐明脑组织及脑血管对不同放射剂量的反应以提高疗效,使之更成功地应用到临床.

Retrospective study on 5 508 cases of intracranial lesion with Gamma knife treatment

Objective To summarize the experience of 5 508 patients with intracranial lesion after Gamma knife treatment.Methods 1 387 patients with pituitary adenoma were treated by Gamma knife, and therapeutic efficacy and methods of 158 patients with giant pituitary adenoma were statistically analysed. Among the 312 patients with acoustic neuroma treated by Gamma knife, 50 patients were recurrent after operation, whose results of follow-up were investigated; the results of follow-up in 460 patients with meningioma were investigated; among 527 patients with arterio-venous malformations, the follow-up results of 130 cases were investigated.Results After treatment the rates of effective therapy of pituitary adenoma, acoustic neuroma, arterio-venous malformation and cerebral metastatic tumor were 98.1%, 41.6%, 83.3% and 81.8% respectively.Conclusion Gamma knife has become one of the most effective therapeutic tools in the neurosurgical field. To improve the therapeutic efficacy, more studies should be conducted on the relevant biological mechanism and individual reaction to explain the reaction of brain tissues and cerebral vessels for different radiation dosage.