旋转式伽玛刀治疗颅内病变1431例初步报告

目的：探讨我国设计的新型立体定向放射外科设备OUR－旋转式伽玛刀治疗颅内病变的可行性及疗效。方法：应用OUR－旋转式伽玛刀治疗颅内病变1431例，男769例，女662例，年龄3－83岁。其中脑血管疾病154（10．7％）例，肿瘤1086（75．9％）例、功能性疾病191（13．3％）例，治疗程序：应用Vectra Ⅱ0．5 Tesla中场超导核磁共振成像系统，行三维薄层扫描，获得定位图像：在rTPS治疗规划系统上应用Version2.5软件交互、自动地对瘤体表预选靶点，敏感组织等结构进行三维图像重建和显示，根据病变不同类型及性质，准确地对治疗参数和治疗剂量进行计算和给定；治疗剂量：周边剂量8－75Gy、等剂量曲线30％－65％，等中心个数1－9个，结果：898例获得12－48个月（平均24．6个月）随访。脑血管畸形血管完全闭塞率44．4％，部份闭塞率41．7％；良性肿瘤生长控制率86．7％－98．8％；恶性肿瘤生长抑制率75．0％－91．0％；功能性疾病症状改善率71．4％－82．3％。严重放射性水肿17例占1．2％（胶质瘤5例、海绵状血管瘤2例、垂体腺瘤3例、脑膜瘤2例、癫痫3例、其它2例）。8例行开颅手术减压、9例经药物治疗后缓解。结论：结果表明，OUR－旋转式伽玛刀治疗颅内病变疗效确切。严格掌适应证，根据病变不同性质、不同体积制定合理治疗方案，是提高疗效的重要措施。

Preliminary reporting of rotating gamma system in 1431 cases of intracranial lesion

Objective: To explore the therapeutic effect of Rotating Gamma System(product of Shnzhen OUR International Technology & Science CO., Ltd., OUR - XGD RGS), which has been utilized to treat intracranial lesions. Method: Between Jan. 1997 and Jan. 2001, 1431 cases of intracrani- al lesions underwent the radiosurgery therapy with RGS at Sichuan Gamma Knife Center. In 1431 cas- es, the ages ranged from 2 to 83 years, and included AVMs in 154(10.7%) cases, tumor in 1986(75. 9 % )cases and functional disorders in 191 (13. 3 % ) cases. The administered marginal dose was 8 to 75 Gy with 30% to 50 % isodose line. Results: The followed - up period were 12 to 48 months (mean 25. 6 months), in 898 of 1431 cases. and the results indicated that: for AVMs, the complete obliteration rate is 44. 4% and the partial obliteration rate is 41. 7%; for tumor, the growth control rate of benign tumor is 86. 7% to 98. 8%, and the growth control rate of the malignant tumor is 75. 0% to 91. 0%; for the functional disorders, the effective rate of epilepsy, parkinson's disease and primary trigminal neuralgia respectively is 79. 4%, 71. 4 %, and 82. 3 %. Conclusion: the results is satisfied. OUR Rota- tion Gamma System can be safely and success fully used to treat intracranial lesions.