X刀治疗脑内病变283例长期随访研究

Long term follow-up results of stereotactic radiosurgery for 283 cases of cerebral lesions

目的:总结X刀治疗脑内病变的长期随访结果。方法:对283例X刀治疗的脑瘤和脑血管畸形患者进行临床和影像学随访,随访时间为1～8年,平均(2.05±4.66)年。结果:82例转移瘤消失35例(42.7％),缩小28例(34.1％),无变化11例(13.4％),增大8例(9.8％);61例胶质瘤消失10例(16.4％),缩小19例(31.1％),无变化16例(26.2％),增大16例(26.2％);55例动静脉畸形消失29倒(52.7％),缩小20倒(36.4％),无变化6倒(10.9％);17例海绵状血管瘤缩小4倒(23.5％),无变化13例(76.5％);35例脑膜瘤消失5例(14.3％),缩小15例(42.9％),无变化13例(37.1％),增大2例(5.7％);12例神经鞘瘤消失3例(25.0％),缩小6例(50.0％),无变化2例(16.7％),增大1例(8.3％);10倒生殖细胞瘤消失8例(80.0％),缩小2例(20.0％);11例其他肿瘤消失2例(18.2％),缩小4例(36.4％),无变化4例(36.4％),增大1例(9.0％)。影像检查还发现病灶有坏死表现99例,囊性变19例,周边环状强化73例,胶质细胞增生20例,暂时性反应性肿大23例,放射性脑水肿28例。结论:X刀对小型脑肿瘤和血管畸形是一种安全有效的治疗方法,X刀治疗的主要并发症是放射性脑水肿。

Objective:To study the long term follow-up results of stereotactic radiosurgery for cerebral lesions. Methods: Two hundred and eighty-three patients with cerebral tumor or cerebral vascular malformation treated with linear accelerator radiosurgery were followed up for 1 to 8 years(averagely 2. 05 years). Results: The tumors or cerebral vascular malformations disappeared in 92 cases, decreased in size in 98 cases, unchanged in 65 case and increased in 28 cases. Necrosis of lesions was found in 99 cases, cystic changes in 19 cases, circumscribed enhancement in 73 cases, gliosis in 20 cases, transient swelling in 23 cases, and brain edema in 28 cases. Conclusion: Stereotactic radiosurgery for small cerebral tumor and cerebral vascular malformation is safe and effective with edema as the major complication.