中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2011年
10期
984-986
,共3页
刘东%徐德生%张志远%李彦和%刘晓民%张宜培%贾强%林益光%宋国祥
劉東%徐德生%張誌遠%李彥和%劉曉民%張宜培%賈彊%林益光%宋國祥
류동%서덕생%장지원%리언화%류효민%장의배%가강%림익광%송국상
伽玛刀%放射外科%眼眶肿瘤
伽瑪刀%放射外科%眼眶腫瘤
가마도%방사외과%안광종류
Gamma knife surgery%Radiosurgery%Orbital tumor
目的 总结评价Leksell伽玛刀治疗眼眶肿瘤的中长期疗效.方法 223例患者年龄4~85岁,平均(37.5±15.6)岁.男91例,女132例;125例为手术后残留或复发者,98例根据典型临床及影像表现进行诊断;肿瘤容积0.03~35.60 cm3,平均(5.4±1.9)cm3;肿瘤边缘剂量10~40 Gy.结果 随访18 - 114个月,平均(35.7±16.2)个月,肿瘤缩小129例(57.8%),无变化80例(35.9%),14例(6.3%)肿瘤增大,肿瘤控制率为93.7%;142例患者治疗后视力得到保留,其中视力提升79例,减退19例;21例曾出现一过性球结膜水肿.结论 伽玛刀治疗眼眶肿瘤可取得良好肿瘤控制率,多数患者可保留视力,并发症少,可成为眼眶肿瘤的主要治疗方法之一.
目的 總結評價Leksell伽瑪刀治療眼眶腫瘤的中長期療效.方法 223例患者年齡4~85歲,平均(37.5±15.6)歲.男91例,女132例;125例為手術後殘留或複髮者,98例根據典型臨床及影像錶現進行診斷;腫瘤容積0.03~35.60 cm3,平均(5.4±1.9)cm3;腫瘤邊緣劑量10~40 Gy.結果 隨訪18 - 114箇月,平均(35.7±16.2)箇月,腫瘤縮小129例(57.8%),無變化80例(35.9%),14例(6.3%)腫瘤增大,腫瘤控製率為93.7%;142例患者治療後視力得到保留,其中視力提升79例,減退19例;21例曾齣現一過性毬結膜水腫.結論 伽瑪刀治療眼眶腫瘤可取得良好腫瘤控製率,多數患者可保留視力,併髮癥少,可成為眼眶腫瘤的主要治療方法之一.
목적 총결평개Leksell가마도치료안광종류적중장기료효.방법 223례환자년령4~85세,평균(37.5±15.6)세.남91례,녀132례;125례위수술후잔류혹복발자,98례근거전형림상급영상표현진행진단;종류용적0.03~35.60 cm3,평균(5.4±1.9)cm3;종류변연제량10~40 Gy.결과 수방18 - 114개월,평균(35.7±16.2)개월,종류축소129례(57.8%),무변화80례(35.9%),14례(6.3%)종류증대,종류공제솔위93.7%;142례환자치료후시력득도보류,기중시력제승79례,감퇴19례;21례증출현일과성구결막수종.결론 가마도치료안광종류가취득량호종류공제솔,다수환자가보류시력,병발증소,가성위안광종류적주요치료방법지일.
Objective The authors evaluate their results when using gamma knife surgery (GKS) in the management of patients with orbital tumors.Method Clinical evaluation of 223 patients with orbital tumors treated with GKS from Sep 1995 through Oct 2009 was analyzed retrospectively.The series included 91 male and 132 female patients with a mean age of (37.5±15.6) years (range 4~85 years).The diagnoses were based on pathological analyses in 125 patients,and presumed by characteristic clinical and radiographic findings in 98 patients.There were 94 meningiomas,45 epithelial tumors of the lacrimal gland,25 schwannomas,20 malignant choroidal melanomas,12 optic nerve gliomas,11 orbital metastases,10 pseudotumors of the orbit,3 retinoblastomas and 3 fibromatosis.The median target volume was 5.4 cm3 (range 0.03 ~ 35.60 cm3 ).The tumor margin dose ranged from l0 to 40 Gy.Results Atamedianfollow-upperiodof(35.7±16.2) months (range,18 to 114 months),tumor shrinkage was observed in 129 patients (57.8% ),and the tumor size was stable in 80 (35.9% ).Persistent neuroimaging demonstrated evidence of progression in only 14 patients (6.3% ):10 cases underwent repeated GKS and 4 accepted surgical treatment.Visual acuity was preserved in 142 patients.79 patients experienced some degree of visual sight improvement.Severe deterioration of visual acuity was found in 19 of 161 patients who had useful visual sight before treatment.21 patients (9.4% ) experienced transient conjunctival edema,no other serious acute side effect was observed.Conclusions Gamma knife provides an effective management strategy in patients with orbital tumors; it achives excellent neurological founction preservation and few treatment- related complications.