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目的探讨伽玛刀放射外科治疗良性颅底脑膜瘤中长期疗效和不良反应。方法选取了1998-2003年治疗的获得完全随访资料的颅底脑膜瘤患者166例,全组患者肿瘤体积0.42- 43.4cm3,平均(7.2±3.9)cm3,给予周边剂量平均(12.4±2.6)Gy,中心剂量平均(27.9±5.9)Gy,其中12例患者采用肿瘤体积分割二阶段治疗。对治疗前后的影像学改变、KPS评分和神经功能缺损评估。结果平均随访期为(55.4±18.2)个月(36-96个月)。总体控制率为95.2%(158/166);KPS评分得到显著提高,神经症状总体满意率为94.5%(157/166),主要副作用是放射性脑水肿11例(6.6%),有5例(3%)患者出现新的神经缺损。结论伽玛刀放射外科可以作为有手术禁忌或拒绝手术治疗体积较小脑膜瘤患者的首选性治疗,也可以作为颅底较大脑膜瘤开颅术后的辅助性治疗,能够较长期控制肿瘤复发,提高或保持患者的生存质量。
Objective To investigate the long-term effects and adverse reactions of gamma knife radiosurgery in the treatment of benign basilar meningiomas. Methods A total of 166 patients with skull base meningioma who received complete follow-up data from 1998 to 2003 were selected. The tumor volume was 0.42-43.4 cm 3 in the whole group (mean ± SD 7.2 ± 3.9) cm 3, mean peripheral dose was (12.4 ± 2.6) Gy , The median dose (27.9 ± 5.9) Gy, of which 12 patients treated with tumor volume segmentation two-stage treatment. Imaging changes before and after treatment, KPS score and neurological deficit assessment. Results The average follow-up period was (55.4 ± 18.2) months (36-96 months). The overall control rate was 95.2% (158/166); KPS score was significantly improved, the overall satisfaction rate of neurological symptoms was 94.5% (157/166), the main side effects were radioactive brain edema in 11 cases (6.6%), and 5 cases (3 %) Patients with new neurological deficits. Conclusion Gamma knife radiosurgery can be used as the preferred treatment for patients with small meningioma who have contraindications to surgery or who refuse surgery. They can also be used as adjunctive therapy after craniotomy for large meningioma in the skull base, and can control tumor recurrence in the longer term , Improve or maintain the quality of life of patients.