脑SPECT引导低剂量放疗治疗难治性外伤性癫初探

Preliminary study of low-dose radiation therapy guided by the brain SPECT for refractory post-traumatic epiepsy

目的 探讨脑SPECT（单光子发射计算机断层扫描）对难治性外伤性癫（癎）的定位价值和经其引导低剂量放疗的疗效.方法 分析2004-07-2008-07收治的26例难治性外伤性癫（癎）患者,利用发作期及间期脑SPECT对比确定致（癎）灶后经三维适形NOVALS放射治疗,治疗后口服抗癫（癎）药物至少1 a,随访4～8 a.结果 满意（Engel Ⅰ）7例,显著改善（Engel Ⅱ）14例,良好（Engel Ⅲ）3例,无效（Engel Ⅳ）2例,无加重,总有效率88.5%,优良率76.9%.结论 利用发作期及间期脑SPECT对比引导低剂量放疗是治疗外伤性癫（癎）的有效方法.

Objective To explore the positioning value of brain SPECT（single photon emission computed tomography） in refractory posttrarnatic epilepsy and efficacy of low-dose radiation therapy guided by it. Methods From July 2004 to July 2008 26 cases of patients with refractory posttraumatic epilepsy were confirmed epileptic lesions by comparation between the ictal and interictal brain SPECT, then given three-dimensional conformal radiation treatment NOVALS, after treatment with oral anti- epileptic drugs for at least 1 year and followed up for 4-8 years. Results Satisfaction （Engel I ） 7 cases, significant improve- ment （Engel II ） 14 cases, improvement （Engel Ⅲ） 3 cases. Invalid （Engel IV） 3 cases, the heavier 0 cases, the total effective rate was 88.5%, and rate of satisfaction and significant improvement was 76.9%. Conclusion Using the ictal and interietal brain SPECT comparation to guide low-dose radiotherapy may be an effective method for the treatment of refractory posttrau- matic epilepsy.