颅底脑膜瘤立体定向放射治疗与手术相结合初探

The Preliminary Study of the Stereotactic Radiosurging Combined with Surgical Operation for Meningioma in Skull Base

目的:探讨立体定向放射治疗颅底脑膜瘤与开颅手术相互关系和必要性。方法:回顾性分析了43例颅底脑膜瘤手术加立体定向放射治疗和手术加立体定向放射治疗再加手术治疗以及立体定向放射治疗后再行手术的临床资料。结果:本组43例全部随访12-48月。其中12例手术加立体定向放射治疗12月缩小率为25．00％,48月缩小率为66．69％．肿瘤控制率100％。19例手术加立体定向放射治疗再加手术治疗肿瘤控制率94．74％,无效率5．26％。12例行立体定向放射神经治疗后再行手术治疗,肿瘤控制率91．67％无效率9．33％。结论:对于血运丰富的肿瘤经立体定向放射治疗后在开颅手术中出血少、损伤轻、肿瘤大部能全切。手术加立体定向放射治疗和手术加立体定向放射治疗再加手术成为提高治脑膜瘤疗效的又一种选择。

Objective：Discuss the correlation and necessities of the stereotactic radiotherapy combined with surgical operation for meningiorna in skull base. Methods： A retrospective analysis of 43 cases underwent aecepted stereotactic radiotherapy after operation or stereotactic radiotherapy poste operation followed with operation and operation after stereotactic radiotherapy were performed. Results： The 43 cases were followed up for 12 to 48 months. The tumor volume in 12 cases that the stereotactic radiotherapy added to the surgical operation contract rate was 25.00% after 12 months, the tumor volume contract rate was 66.69% after 48 months, All tumor volume were controlled in 12 cases. The tumor volume in 19 cases that he surgical operation was performed again behind the stereotactic radiotherapy added to the surgical operation was controlled for 94. 74%, couldn＇t be controlled for 5.26%. The tumor volume in 12 cases that the surgical operation added to the stereotactic radiotherapy could be controlled for 91.67%, couldn＇t be controlled for 9. 33%. Conclusion： Meningiorna with blood in abundance after the stereotactic radiotherapy was bleeding little in surgical operation,hurt lightly, big department of tumor removed. The stereotactic radiotherapy combined with surgical operation for meningiorna in skull base become an effect choice.