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伽玛刀单、双靶点治疗原发性三叉神经痛疗效比较 被引量:1

Comparative Analysis on Double or Single Target Points of Gamma Knife Radiosurgery for Trigeminal Neuralgia
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摘要 目的:观察伽玛刀单靶点与双靶点治疗原发性三叉神经痛(ITN)的疗效。方法:INT患者220例,均使用OUR-XGD伽玛刀,4mm准直器行患侧三叉神经立体定向放射外科治疗,单靶点治疗82例,双靶点治疗138例。单靶点置于三叉神经感觉根桥脑进入区,双靶点置于三叉神经感觉根桥脑与半月神经节之间。两组均为中心剂量70~90 Gy,以50%等剂量线包绕;脑干表面以20%等剂量线包绕,剂量<14Gy。结果:随访9个月~11年,平均67个月。单靶点组有效68例(82.9%),无效14例(17.1%),复发11例(13.4%),并发症5例(6.1%);双靶点组有效130例(94.1%),无效8例(5.8%),复发6例(4.3%),并发症14例(10.1%)。两组治疗有效率、复发率比较,差异有统计学意义(P<0.05),并发症发生率比较,差异无统计学意义(P>0.05)。结论:伽玛刀治疗三叉神经痛安全有效。双靶点治疗疗效优于单靶点,复发率低。 Objective:To Compare the therapeutic effects of double with single target point of gamma knife radiosurgery for idiopathic trigeminal neuralgia(ITN). Methods:A total of 220 patients with/TN in our center were operated on via a OURXGD Gamma knife unit with a collimator of 4 ram, among whom 82 were treated using single target point in the trigeminal root entry zone(REZ) and other 138 with double points,one located in the REZ,the other near the trigeminal ganglion. In both groups,the central dose varied from 70 to 90 Gy, and the isodose was 50% ;20% isodose line was tangential to the hrainstem surface with a dose limited to 14 Gy. Results:Follow-up ranged from 9 to 132 months (median,67 months). The pain relief patients of single- and double-isocenter group were 68 ( 82.9% ) and 130 ( 94.1% ), respectively, meanwhile, 11 patients (13.4%) experienced pain recurrence 9 months after being completely free from pain in the single target point group as compared to 6 patients(4.3% ) in tile double target point group. The pain relief rate and pain recurrence rate in 2 groups had a statistical difference ( P 〈 0.05). The complication rate of tbe double target point group was 14 ( 10.1% ) and 5 ( 6.1% ) in the single target point group, with no statistical difference ( P 〉 0.05 ). Conclusion : Gamma knife radiosurgery is a safe and effective metbod for trigeminal neuralgia. Double target point strategy may have better pain relief and less pain recurrence than single one.
机构地区 浙江省人民医院
出处 《浙江中西医结合杂志》 2010年第6期334-335,381,共3页 Zhejiang Journal of Integrated Traditional Chinese and Western Medicine
关键词 原发性三叉神经痛 伽玛刀治疗 单靶点 双靶点 trigeminal neuralgia gamma knife single target double target
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