颅内肿瘤伽玛刀治疗后并发症原因分析

Analysis of the Complications in the Patients with Intracranial Cancer Treated with γ-Knife Therapy

[目的]探讨伽玛刀治疗颅内肿瘤产生井发症的原因。（方法）回顾性分析接受价玛刀治疗后出现并发症的18例患者的临床资料。［结果］颅内肿瘤伽玛刀治疗后并发症的发生率为6％（18/300）。12例患者表现为颅内压增高和神经功能缺失，4例出现新的神经功能缺失，2例脑疝；肿瘤最大直径均大于3．0cm，且多位于中线结构及主要回流静脉附近；11例保守治疗，7例行手术治疗，无一例死亡。[结论]颅内肿瘤伽玛刀治疗后并发症的发生主要与颅内肿瘤的大小、形态及部位等因素有关。选择合理的治疗剂量和剂量曲线可能降低伽玛刀治疗后并发症的发生。

[Purpose]To investigate the cause of complications in the patients treated With γ knife.[Methods]Clinical materials of 18 cases withcomplications caused by γ-knife therapy were analysed retrospectively.[Results]The incidence of the complications in patients with intracranialneoplasm after γ-knife therapy was 6% (18/300). Among them, increased ICP and neurological deficit were occured in 12 patients,additionalneurological deficit in four and cerebral hemiation in 2 cases. The largest diameter of intracranial tumors in all cases was over 3.0 cm and mosttumors were located in near-by midline and main drawing veins.All the complications were managed by conservative or surgical theapies (11 casesand 7 cases). [Conclusion]The complications occured in patients undergone γ-knife therapy are related mainly to the size and shape of the tumor andits location.Rational therapeutical dose and dose curve may reduce the incidence of the complication caused by γ-knife therapy.