分次立体定向放射治疗听神经瘤临床分析

Fractionated Streotatic Radiotherapy For Acoustic Neuroma

目的评价立体定向放射治疗听神经瘤的局部控制率及毒副反应。方法我们对65例听神经瘤患者进行分次立体定向放射治疗,所有这些病人均有患侧听力的进行性下降或肿瘤进行性增大,或两者兼有。肿瘤的最大径在MRI上测量,平均3.2cm(1.8～3.8),接受剂量为2000～2400CGy/5～6次(80%等剂量曲线),所有病人均只有一个等中心。结果随访12～62个月,平均26个月,5年局部控制率为93%,听力保护率为75%,三叉神经功能保护率为92%,无面瘫、脑积水及其它并发症发生。结论分次立体定向放射治疗能有效的控制肿瘤的生长,听力保留率高,其它毒副反应小。

Objective To assess the local eontral and toxicity rate in acoustic neuroma patients treated with fraetionated streotatie radiotherapy. Methods We evaluated 65 patients treated with fractionated streotatie radiotherapy. All patients had progressive tumors, progressive symptoms,or both. Mean tumors diameter was 3.2cm,（1.8-3.8） on magnetic resonance （MR）scan. The patients were given a dose of 2000-2400CGy/5-6f prescribed to the 80% isodose. All patients were treatd with a single isocenter. Results With a mean follow-up period of 26 months （12-62）, the actuarial local eontral rate at 5 years was 93%. The actuarial rate of hearing preservation at 5 years was 75% in previously-hearing patients. The actuarial local of freedom from rigeminal nerve toxicity was 92% at 5 years. No patients developed facial nerve toxicity or other complications. Conclusion Fraetionated streotatie radiotherapy give excellent local contral in acoustic neuroma. It combines a high rate of preservation of hearing with a very low rate of other toxicity.