伽玛刀立体定向放射外科治疗原发性顽固性三叉神经痛的临床研究

Clinical Study on Gamma Knife Radiosurgery for Trigeminal Neuralgia

目的：通过对治疗病例的随访，评价伽玛刀治疗原发性顽固性三叉神经痛的有效性和安全性。方法：应用美国GE1．5TMRI定位，OUR-XGD型旋转式伽玛刀治疗原发性顽固性三叉神经痛患者10例，治疗靶点定为三叉神经根入桥脑处，采用4mm准直器，设1～2个等中心点，中心剂量80～85Gy，以50％等剂量曲线覆盖靶点，脑干边缘剂量12～15Gy。结果：随访时间6～24个月，治愈6例，疗效显著1例，显效1例，无效2例，总有效率（治愈＋显著＋显效）80％，无明显并发症。结论：伽玛刀放射外抖治疗原发性三叉神经痛安全有效，对药物等保守治疗无效的顽固性三叉神经痛患者可首选伽玛刀治疗。

Objective：To assess the safety and efficacy of gamma knife radiosurgery for trigeminal teuralgia. Methods：10 patients with trigeminal neuralgia were fixed by GE 1.5 TRMRI and treated by OUR- XGD gamma knife. The entry zone of trigeminal nerve root was fixed as the radiotherapeutic target. 1 or 2 isocenter points were placed. The radiation dose at brainstem surface was between 12 and 15 Gy, and the central dose was between 80 and 85 Gy. Results ：All patients were followed up between 6 and 24 months. 6 patients was cured, 1 effectively improved, 1 improved and 2 ineffective. The total effective rate was 80 %. There was no serious complication. Conclusion： Gamma knife radiosurgery is safe and effect in treatment of trigeminal neuralgia. It is the first choice for treating trigeminal neuralgia with ineffective conservative treatment.