侵袭前中颅窝底颅外恶性肿瘤的伽玛刀治疗

THE GAMMA KNIFE TREATMENT OF THE EXTRACRANIAL MALIGNANT TUMORS INVADED THE BASE OF ANTERIOR-MIDDLE CRANIAL FOSSA

目的：探讨伽玛刀对侵袭前中颅窝底颅外恶性肿瘤的治疗效果。方法：对１０例侵袭前中颅窝底的颅外恶性肿瘤实施了伽玛刀治疗，肿瘤的病理性质包括鼻咽癌、上颌窦鳞癌、腮腺混合瘤恶变及泪腺囊性腺样癌。肿瘤体积０５～３１１ｃｍ３（平均１３６ｃｍ３），周边治疗剂量１３～２０Ｇｙ（平均１７９Ｇｙ），周边剂量曲线３０％～６０％（平均４３３％）。结果：随访３～１１个月（平均６７５月），其中６例（７个病灶）影像学检查提示有５个病灶体积缩小，１个病灶消失，另１个病灶无变化。全组临床症状无加重。结论：伽玛刀对于侵犯前中颅窝底的颅外恶性肿瘤的治疗效果满意，值得进一步研究。

Objective: To explore the therapeutic efficacy of Gamma knife on the extracranial malignant tumors invading the base of anterior-middle cranial fossa. Methods: 10 patients suffering from extracranial malignant tumor invading the base of anterior-middle cranial fossa were treated by Gamma knife. Tumors revealed by pathalogic examinations included nasopharygeal carcinoma, squamous cancer in maxillary sinus, malignant parotid gland mixed tumor and lacrimal gland cancer. The ranges of tumor volumes, margin doses and peripheral curves were 0 5～31.1cm 3 (mean 13.6cm 3), 13～20Gy(mean 17.9Gy) and 30%～60% (mean 43.3%) respectively. Results: All cases were followed up in 3～11 months (mean 6.76 months). In 6 cases (7 lesions) tumor volumes decreased in 5 and disappeard in one, and in the other the mass remained unchanged. The clinical symptoms did not deteriorate in all patients. Conclusion: Gamma knife shows satisfactory therapeutic efficacy on the extracranial malignant tumors invading the base of anterior-middle cranial fossa.