伽玛刀治疗颅内疾病3094例临床报告

The Preliminary report of 3094 cases of intracranial diseases treated by gamma knife

目的： 探讨立体定向放射手术（伽玛刀） 对颅内疾病的疗效。方法： 用１．５Ｔｅｓｌａ 磁共振仪和γ－ ｐｌａｎ 计算机联网定位， γ－ ｐｌａｎ４．０ 版剂量规划系统作治疗方案设计， 剂量规划， 对３０９４ 例不同类型的颅内疾病包括肿瘤、血管畸形及功能性疾病等实施立体定向放射外科治疗， 病种达２０ 余种，年龄１．１～８６ 岁，周边剂量９～７５Ｇｙ，中心剂量１８～１５０Ｇｙ，等剂量曲线３０％ ～９０％ ，靶点数１～１２ 个。结果： 随访１０～４７ 个月， 统计结果表明： 伽玛刀疗效是确切的。对脑动静脉畸形， 随防一年半以上， 完全闭塞率可达４４．６％ ， 体积越小， 周边照射剂量越大， 闭塞率越高。对颅内肿瘤的生长控制率， 良性肿瘤≥８０．０％ ， 恶性肿瘤≥６６．７％ ，对功能性疾病的治疗有效率， 帕金森病为８５．２％ ， 三叉神经痛为７６．９％ 。结论： 伽玛刀是治疗颅内疾病又一种可选择方法。治疗技术良好， 指征掌握严格， 可提高疗效， 降低并发症。

Objective:To explore the therapeutic efficiency of the intracranial diseases with the gamma knife stereotactic radiosurgery.Method:3094 cases with different intracranial diseases including tumor,AVMs,functional disorders were treated by gamma knife.The localization of the treatment was used by 1.5 Tesla MRI and transmit the images from the network workstation to the gamma plan system to device dose plans.The kinds of intracranial disases were superior to twenty. The patient ages ranged from 1.1 to 86 years.The administered peripheral dose was 9 to 75 Gy.center dose was 18 to 150 Gy. The number of shots were 1-12.Results:The 10-47 months followed-up indicates that the treatment result of gamma knife is satisfied. For AVMs of followed-up 1.5 years,the complete obliteration rate was more than 44.6%.The volume of AVMs is smaller,or the peripheral dose is larger,the obliteration rate is higher.For growth control rate of tumor,the benigh tumors>80.0%,and malignant tumors>66.7%,respectively.For the effective rates of functional disorders,Parkinson's diseases,primary trigminal neuralgia,epilepsy respectively is 85.5%,76.9%,and 66.7%.Conclusion:The gamma knife radiosurgery is a effective method.So long as grasp the indications strickly and the administered dose acurately,may improve the therapeutic efficiency and decrease complications.