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目的探讨立体定向放疗治疗(stereotactic radiotherapy,SRT)脑干区肿瘤适应证、方法及临床疗效。方法应用立体定向放疗治疗(SRT)脑干区肿瘤21例;其中胶质瘤9例、血管瘤4例、转移瘤4例、胶质瘤手术后残留4例。治疗方法采用如下3种方案:1外照射加SRT追量,包括8例高级别胶质瘤(3~4)和2例转移瘤。在外照射量30~36Gy基础上,SRT追量18~30Gy。2低级别胶质瘤(1~2)术后残留及复发,共7例。SRT靶区剂量40~45Gy,分8~12次、每天一次。3良性肿瘤的4例;分别为动静脉瘤(AVM s)及血管瘤(CA)2例。靶区剂量35~40Gy,分4~6次,隔天治疗。结果治疗后12个月生存率20例,临床症状近期好转率20例,死亡1例。立体定向放射治疗脑干肿瘤2年生存率达85.7%。结论立体定向放射治疗脑干区肿瘤安全有效:病灶剂量、分割治疗方式及适应证选择是关键。
Objective To investigate the indications, methods and clinical effects of stereotactic radiotherapy (SRT) in the brainstem region. Methods Stereotactic radiotherapy (SRT) brain stem region in 21 cases; 9 cases of glioma, 4 cases of hemangiomas, 4 cases of metastases, 4 cases of residual glioma after surgery. Treatment using the following three programs: 1 external beam plus SRT volume, including 8 cases of high-grade glioma (3 ~ 4) and 2 cases of metastases. In the external dose of 30 ~ 36Gy basis, SRT volume 18 ~ 30Gy. 2 low-grade glioma (1 ~ 2) residual and recurrence after surgery, a total of 7 cases. SRT target dose 40 ~ 45Gy, points 8 to 12 times a day. 3 benign tumors in 4 cases; respectively, aneurysm (AVM s) and hemangioma (CA) in 2 cases. Target dose 35 ~ 40Gy, points 4 to 6 times, the next day treatment. Results The survival rate of 12 months after treatment was 20 cases, the clinical symptom improvement rate was 20 cases and 1 case died. Stereotactic radiotherapy of brain stem tumor 2-year survival rate of 85.7%. Conclusion Stereotactic radiation therapy is safe and effective in the treatment of tumors in the brain stem area: the dose of the lesions, the method of treatment and the choice of indications are the key points.