伽玛刀放射治疗听神经瘤的长期疗效分析

Long-term Following Up and Analysis of Curative Effect of Gamma Knife Radiosurgery on Acoustic Neuromas

目的总结评价伽玛刀放射治疗对听神经瘤生长的控制作用和对肿瘤周围的颅神经功能变化的影响。方法从1997年至2005年我科伽玛刀中心采用多中心点照射治疗159例(164个)听神经瘤,其中137例有完整的随访资料。MRI随访6～96个月,平均37.2个月;临床随访6～116个月,平均36.4个月。单纯行伽玛刀治疗86例,开颅手术后再行伽玛刀治疗51例。结果肿瘤控制率为94.16%;肿瘤体积增大8例(5.84%)。术前有听力的106例患者中听力保留率为72.64%,听力下降率为27.36%。面神经功能保留率为95.50%,三叉神经功能保留率为94.16%。结论伽玛刀治疗听神经瘤有良好的控制效果,并发症少,对肿瘤周围颅神经有较高的功能保留作用。

Objective To evaluate the effect of the Gamma knife radiosurgery （GKRS） on acoustic neuromas and the function of peritumorous cranial nerves. Methods GKRS was performed in 159 patients with 164 acouslic neuromas from 1997 to 2006 in our department, out of whom, 137 were followed up with MRI from 6 to 96 months （mean, 37.2 months） and with clinical examination from 6 to 116 months （mean, 36.4 months）. Of 137 patients followed up, 51 underwent craniotomy before GKRS and 86 only received GKRS. Results The effective rate of controlling tumors was 94.16%. Out of 137 cases of tumors, 8 enlarged. The hearing was preserved in 72.64% of and the hearing was deteriorated in 27.55% of the patients with preoperative hearing. The rate of facial nerve preservation was 95.49% and the rate of trigeminal nerve function preservation was 97.47%. Condusions GKRS is an effective method to treat acoustic meuromas. The relative few complications are caused by GKRS, which can not do damage to the peritumorous cranial nerves.