伽玛刀治疗听神经瘤229例疗效分析

Analysis of curative effect of gamma knife radiosurgery on 229 cases of acoustic neuromas

目的评价伽玛刀治疗听神经瘤的疗效。方法采用OUR旋转式伽玛刀治疗229例听神经瘤患者,观察术后病情变化。结果本组伽玛刀治疗病例随访6～60个月,其中肿瘤缩小98例,肿瘤体积不变115例,肿瘤增大16例,治疗前存在有用听力病例中38例听力下降;130例患者有用听力得到保留;54例出现患侧面瘫;11例出现三叉神经功能部分受损。结论伽玛刀对听神经瘤有较高的肿瘤控制率,并能保留有用听力,对面神经、三又神经损伤小,是小至中等大小听神经瘤可供选择的治疗方法,及术后残余和复发肿瘤的重要辅助治疗手段。

Objective To evaluate the effect of the gamma Knife radiosurgery on acoustic neuromas. Methods 229 patients with acoustic neuromas were treated with OUR Rotating Gamma System, and the postoperative condition was observed. Result Follow-up ranged from 6 to 60 months in the group,tumor size reduced in 98 patients,remained unchanged in 115 and increased in 16. Functional hearing was reduced in 38 patients and preserved in 130 who had useful hearing prior to gamma knife treatment. 54 patients developed new facial paralysis and 11 developed trigeminal injury. Conclusion Gamma -knife radiosurgery achieves high tumor control rate for acoustic neuromas with preservation of functional hearing, minimal facial and trigeminal injury. It provides an optional treatment for patients with small to medium size acoustic neuromas, and an important adjuvant therapy for treating residual and recurrent tumors.