^186Re内放射治疗颅咽管瘤的临床疗效

Curative effect of stereotactic ^186Re endocavitary irradiation on cystic craniopharyngioma

目的 评价应用立体定向肿瘤囊腔内注射^186Re治疗颅咽管瘤的临床效果.方法 应用立体定向穿刺置管注射^186Re方法治疗囊性或囊实性颅咽管瘤19例,其中男性12例,女性7例.年龄5～58岁,平均37.2岁.肿瘤呈囊性者12例,囊实性者7例.注射核素^186Re前,颅咽管瘤囊性部分的平均体积为8390 mm^3.结果 随访6个月至3年,有7例患者囊腔完全消失,囊腔体积缩小〉50%以上者5例,囊腔体积缩小≤50%者7例.治疗前视力减退的8例患者中,5例患者治疗后视力显著改善.治疗前垂体功能正常者无一例出现垂体功能低下 而治疗前垂体功能低下的4例患者中,1例治疗后垂体功能改善.治疗前表现为尿崩症的5例患者中,3例治疗后尿崩症状改善.结论 立体定向肿瘤囊腔内注射^186Re是治疗囊性或囊实性颅咽管瘤简单、安全、有效的方法.

Objective To evaluate the treatment results of stereotactic ^186Re intracavitary irradiation in the patients with craniopharyngioma. Methods Nineteen patients were treated with stereotactic ^186Re intracavitary irradiation, including 12 males and 7 females （average age, 37. 2 years）. Among them 12 patients had a solitary cyst, whereas 7 patients with mixed structure （e. g. , a large cyst with a small solid portion）. The mean volume of the cystic portion of the tumor before irradiation was 8390 mm^3. Results The patients were followed up for 6 months to 3 years. The retraction of the cyst was complete in 7 patients, cyst volume decreased more than 50% in 5 patients and less than 50% in 7 cases. Among the 8 patients with visual acuity deficit before irradiation, 5 were improved. No hypopituitarism occurred in patients with normal pituitary function before treatment. One of the 4 patients with hypopituitarism was improved, 3 of the 5 patients with diabetes insipidus was improved. Conclusion Stereotactic 186Re endocavitary irradiation for the treatment of cystic craniopharyngioma is a safe and effective procedure.