CAJ | 학술논문

目的探讨伽玛刀放射外科治疗颅内软骨肉瘤的临床疗效. 方法回顾性分析天津医科大学第二医院神经外科伽玛刀中心自2004年11月至2012年1月收治的4例软骨肉瘤患者诊治过程.4例患者均行手术切除并经病理证实,其中男1例,女3例；年龄26～36岁,平均31.3岁.肿瘤体积0.6～25.4 cm3,平均13.8 cm3;边缘剂量15～20 Gy,平均17.3 Gy;中心剂量30～40 Gy,平均35 Gy;靶点数4～19个,平均10个.本组随访时间5～28个月,平均14.5个月. 结果 1例左侧乳突及颈静脉孔区患者及1例鞍区患者治疗后分别随访19个月、9个月,肿瘤未见增大,生存良好；1例右侧眶颅沟通患者随访28个月后复发,后两次行手术治疗,效果不佳,于伽玛刀治疗后56个月死亡；1例左侧鞍旁患者治疗后5个月肿瘤复发,伴脑积水,随后失访.4例均未出现任何与伽玛刀治疗相关的并发症. 结论伽玛刀治疗定位精确度高,疗效可靠且对周围组织损伤小,可作为术后残留软骨肉瘤辅助治疗方法.
목적 탐토가마도방사외과치료로내연골육류적림상료효. 방법 회고성분석천진의과대학제이의원신경외과가마도중심자2004년11월지2012년1월수치적4례연골육류환자진치과정.4례환자균행수술절제병경병리증실,기중남1례,녀3례；년령26～36세,평균31.3세.종류체적0.6～25.4 cm3,평균13.8 cm3;변연제량15～20 Gy,평균17.3 Gy;중심제량30～40 Gy,평균35 Gy;파점수4～19개,평균10개.본조수방시간5～28개월,평균14.5개월. 결과 1례좌측유돌급경정맥공구환자급1례안구환자치료후분별수방19개월、9개월,종류미견증대,생존량호；1례우측광로구통환자수방28개월후복발,후량차행수술치료,효과불가,우가마도치료후56개월사망；1례좌측안방환자치료후5개월종류복발,반뇌적수,수후실방.4례균미출현임하여가마도치료상관적병발증. 결론 가마도치료정위정학도고,료효가고차대주위조직손상소,가작위술후잔류연골육류보조치료방법.
Objective To discuss the clinical effect of gamma knife radiosurgery on patients with intracranial chondrosarcoma.Methods Four patients with residual chondrosarcoma (one male and three female),admitted to our hospital from November 2004 to January 2012 and verified by biopsy,were chosen in our study; their clinical data were retrospectively analyzed; the mean age of patients was 31.3 years (ranged from 26-36 years).The mean tumor volume of these patients by gamma knife radiosurgery was 13.8 cm3 (ranged from 0.6-25.4 cm3).The mean dose delivered to the tumor margin was 17.3 Gy (ranged from 15-20 Gy) and the mean tumor maximum dose was 35 Gy (ranged from 30-40 Gy).A mean often isocenters (range 4-19) were used for dose planning.All patients were followed up for 5 to 28 months (mean 14.5 months).Results Two patients had residual chondrosarcoma located in the left mastoid,and jugular foramen area and saddle area were followed up for 19 and 9 months,respectively;their tumors did not increase and the patients were alive and enjoyed good living.Recurrence happened inone patient had the right residual orbit-cranial communicating chondrosarcoma at 28 months of follow-up; she accepted twice operations because of the recurrent tumors,but the outcome was bad; and she was dead at 56 months after gamma knife treatment.One patient had residual chondrosarcoma in the left parasella appeared tumor recurrence with hydrocephalus at 5 months of follow-up,and then,follow up was lost.All the four patients had no complications associated with gamma knife radiosurgery.Conclusion Gamma knife radiosurgery can be an auxiliary therapy for residual chondrosarcoma after craniotomy,enjoying advantages as high accuracy,reliable clinical efficacy,being less damage to the surrounding tissues.