伽玛刀^(60)Co1.5个半衰期后治疗颅内病变187例初步报告

Preliminary reporting of 187 cases of Intracranial lesions with gamma knife after ^(60)Co source 1.5 HVL

目的回顾分析伽玛刀60Co源1.5个半衰期后治疗颅内病变187例的临床效果。方法2003年7月～2004年12月我院伽玛刀60Co源处于1.5个半衰期后,治疗颅内病变有追踪及资料完整者187例(治疗组A)。男101例,女86例;年龄9～80岁,平均43.4岁。颅内肿瘤154例(82.4%),脑动静脉畸形(AVM)27例(14.4%),原发性三叉神经痛6例(3.2%)。治疗周边剂量12～38Gy,中心剂量25～76Gy,40%～70%等剂量曲线包绕病灶,靶点数1～10个。视神经、视交叉辐射剂量小于8～9Gy,脑干辐射剂量小于15Gy。同时选择1995年8月～1997年8月,伽玛刀60Co源处于0.5个半衰期,治疗颅内病变资料完整的205例作为对照组B。结果治疗组随访11～27月,平均21.3月,良性肿瘤有效率86.7%～95.9%,恶性肿瘤有效率65%～92.9%,动静脉畸形有效率77.8%,三叉神经痛有效率83.3%。无永久性颅神经损伤。治疗结果与对照组雷同(P>0.05)。结论当60Co源处于1.5个半衰期后,如果给予足够的剂量治疗颅内病变,可以达到伽玛刀60Co源处于0.5个半衰期时的治疗效果。根据上述有限的资料,我们认为伽玛刀60Co源至少可以使用9.5年。

Objective To analyse the therapeutic effect of gamma knife after ^60Co source 1.5 HVL, which has been utilized to treat intraeranial lesions. Methods When ^60Co source after 1.5 HVL from July 2003 to December 2004, 187 eases of intraeranial lesions has been treated with Gamma Knife （ Group A）. In 187 eases of intracranial lesions, the ages ranged from 9 to 80 years, and included tumor in 154 （ 82.4 % ） cases, AVMs in 27 （ 14.4 % ） cases and functional disorders in 6 （ 3.2 % ） cases. The margin dose was 12 - 38Gy the center does was 25 -76Gy, and the isodose was 40%～70% . When ^60Co source was 0.5 HVL, from August 1995 to August 1997, 205 cases of intracranial lesions had been treated with stereotactic radiosurgey （Group B）. Results The followed-up period were 11 to 27 months （ mean 21.3 months ） in 187 cases. The results included that ： for tumor, the growth control rate of benign tumor was 86.7% ～ 95.9% , and the growth control rate of the malignant tumor was 65% ～ 92.9% ; For AVMs, the complete or the partial obliteration rate was 77.8% ; For the functional disorder, the effective rate of primary trigminal neuralgia was 83.3 % in group A. There was no significant difference between Group A and Group B （ P 〉 0.05 ）. Conclusions Satisfied results were got. The ^60Co source of gamma knife can be safely and successfully used for the treatment of intracranial lesions continuing for 9.5 years at least.