颅底脑膜瘤的伽玛刀治疗

Gamma knife radiosurgery in the management of skull base meningiomas

目的研究伽玛刀放射外科治疗颅底脑膜瘤的效果。方法选取了1995-2000年治疗的颅底脑膜瘤患者225例,肿瘤体积平均6.0±5.2cm3,给予中心剂量平均27.5±5.2Gy,周边剂量平均12.3±1.9Gy。随访根据治疗前后的影像表现和Karnofsky行为评分进行评估。结果有完整随访资料患者189例。从总体上,肿瘤的控制率为96.8%;临床表现满意度(好转和稳定)96.3%,并发症少且轻微。结论伽玛刀可作为颅底较大脑膜瘤开颅术后的辅助治疗,也可作为较小肿瘤或对手术禁忌患者的首选性治疗;对长期控制肿瘤复发、保证患者良好的生存质量,起重要的作用。

Objective To evaluate outcome of patients who have undergone Gamma Knife Radiosurgery for basal skull meningiomas. Methods 225 patients harbored meningiomas centered within the basal skull and received gamma knife treatment during 1995-2000. The mean volume of the tumor is 6.0±5.2 cm3. The mean dose applied to the tumor center and tumor margin were 27.5±5.2 Gy and 12.3±1.9 Gy, respectively. Follow-up imaging studies were reviewed, and Karnofsky performance scale scores were recorded, which were compared with the correspondent data before Gamma Knife treatment.Results 189 patients had full data. Totally, Tumor control rate is 96.8%. Clinical status satisfaction [improved or stable]rate is 96.3%. The complications are less and mild. Conclusions Gamma Knife proved to be an attractive additional treatment(for large tumors) and primary treatment(for small tumors or contraindication to surgery) option in selected patients with basal skull meningiomas. It played a significant role on long-term controlling tumor recurrence and ensuring satisfying quality of life.