伽玛刀治疗泪腺上皮性肿瘤的长期疗效观察

Long-term outcomes of gamma knife for epithelial tumors of the lacrimal gland

目的研究伽玛刀治疗泪腺上皮性肿瘤的长期效果、影响因素及并发症。方法回顾性分析59例手术切除后复发的泪腺上皮性肿瘤病人的临床资料,均采用伽玛刀治疗。采用Kaplan-Meier法评估局部控制率和生存率。Cox回归模型用于分析肿瘤复发的危险因素。结果随访59例,时间15~96个月,平均55.6个月。6个月实际控制率是96.6%,1年和5年实际控制率分别是72.9%和15.2%。肿瘤侵犯颅内（P=0.002）和肿瘤直径≥3.5 cm（P〈0.001）是降低治疗效果的危险因素。是否曾行放射治疗对预后影响无统计学意义（P=0.155）。5年远处转移率是32.2%。5年生存率是50.8%。结论伽玛刀作为一种安全有效的无创性肿瘤治疗方法,治疗复发泪腺上皮性肿瘤短期效果良好,但仍需要定期复查。

Objective To analyze the long-term efficacy, influencing factors and complications of gamma knife for epithelial tumors of the lacrimal gland. Methods Clinical data of 59 patients with postoperative recurrent epithelial tumors of the lacrimal gland undergoing gamma knife were analyzed retrospectively. Kaplan-Meier method was used to estimate the tumor control rate and survival rate. A Cox regression model was used to analyze the risk factors of recurrence. Results All the patients were followed up for 15 to 96 months with the mean period of 55.6 months. The actual control rates were 96.6%, 72.9% and 15.2% at 6 months, 1 year and 5 years after gamma knife respectively. No intracranial invasion （P = 0.002） and diameter of tumor ≥ 3.5 cm （P 〈 0.001） were risk factors for decreasing the efficacy. Whether radiotherapy or not before gamma knife showed no statistically significant difference in its influence on the prognosis （P = 0.155）. The 5-year metastasis rate was 32.2%. The 5-year survival rate was 50.8%. Conclusions As a non-invasive technique, gamma knife treatment is safe and effective for epithelial tumors of the lacrimal gland, but regular follow-up is necessary.