伽玛刀治疗原发性三叉神经痛56例疗效分析

The preliminary Clinical study on gamma Knife radiosurgery for treatment of primary trigeminal neuralgia with 56 cases reports

目的 :探讨伽玛刀治疗原发性三叉神经痛的疗效 ,判定治疗剂量与其疗效的关系。方法 :用伽玛刀治疗原发性三叉神经痛 5 6例 ,选择靶点为三叉神经根近端 ,选用 4mm准直器 ,靶点中心剂量为 70～ 90Gy ,并对不同治疗剂量组之间疗效行统计学处理。结果 :5 6例随访 3～ 5 4个月 (平均 31 2个月 ) ,疼痛完全消失 30例 (5 3 6 % ) ,疼痛基本消失 14例 (2 5 % ) ,疼痛缓解 >5 0 %者 7例 (12 5 % ) ,无效 5例 (8 9% ) ,总有效率 91%。中心剂量 <80Gy和≥ 80 %Gy两组在显效率方面存在显著差异 (P <0 0 5 )。 结论 :伽玛刀是治疗原发性三叉神经经一种安全和有效的方法。最佳治疗中心剂量一般考虑为 75～ 90Gy ,产生最佳放射生物学效应的剂量点可能为 80Gy。

Objective:To evaluate the effects of Gamma knife to treating primary trigeminal neuralgia Methods:56 cases of primary trigeminal neuralgia were treated with Gamma knife,the chosen target was the root of trigeminal nerve just anterior to pons,and the target central dose was 70～90Gy。The statistic Processi on was accepted in the efficacy of treatment between different radiosurgery dose groups.Results:56 patients were followed up for 3 to 54 months with mean term of 31.2 months.The pain completely disappeared in 30 cases (53.6%),the pain basically disappeared in 14cases (25%),more than 50% pain relief occurred in 7 cases (12.5%),and in 5 patient(8.9%) the pain was unchanged There was significant difference in pain relief whten we compared<80 Gy to ≥80Gy ( P <0 05 for complete pain plus excellent result).Conclusion:Treatment of primary trigeminal neuralgia with Gamma knife is effective and safe methods.The preferable radiosurgey doses should be 75 to 90 Gy and the preferable radiosurgey doses of site may be 80 Gy.