Lee John Y K, Kondziolka Douglas, Flickinger John C, Lunsford L Dade
Department of Neurological Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pa., USA.
Prog Neurol Surg. 2007;20:142-149. doi: 10.1159/000100101.
Meningiomas are common intracranial benign tumors that can be surgically excised. However, their intimate involvement with critical neurovascular structures often prevent their complete resection. Gamma Knife radiosurgery is a minimally invasive option which provides excellent tumor control as both an adjunct and primary therapy.
Between September 1987 and December 2004, 964 patients underwent Gamma Knife radiosurgery at the University of Pittsburgh for the diagnosis of meningioma. The majority of patients had tumors located at the skull base. All imaging and clinical follow-up was reviewed.
Overall, Gamma Knife radiosurgery provides 5- and 10-year actuarial tumor control rates of 93% for benign meningiomas. The 5-year actuarial control rate for patients with atypical and malignant meningiomas was 83 +/- 7 and 72 +/- 10%, respectively. The incidence of adverse radiation effect ranged from 5.7 to 16%; however, the incidence was gradually reduced with the advent of magnetic resonance imaging and lower dosing since 1991.
Gamma Knife radiosurgery is an attractive option for patients with intracranial meningiomas. It can be used as both primary treatment based on imaging diagnosis alone, or as an adjunct treatment after craniotomy. It provides long-term tumor control with minimal adverse sequelae.
脑膜瘤是常见的颅内良性肿瘤，可通过手术切除。然而，它们与关键神经血管结构的紧密关联常常妨碍其完全切除。伽玛刀放射外科手术是一种微创选择，作为辅助治疗和主要治疗手段都能实现出色的肿瘤控制。
1987年9月至2004年12月期间，964例患者在匹兹堡大学接受伽玛刀放射外科手术以诊断脑膜瘤。大多数患者的肿瘤位于颅底。对所有影像学和临床随访资料进行了回顾。
总体而言，伽玛刀放射外科手术对良性脑膜瘤的5年和10年精算肿瘤控制率为93%。非典型和恶性脑膜瘤患者的5年精算控制率分别为83±7%和72±10%。放射不良反应的发生率在5.7%至16%之间；然而，自1991年以来，随着磁共振成像的出现和剂量降低，该发生率逐渐降低。
伽玛刀放射外科手术对于颅内脑膜瘤患者是一个有吸引力的选择。它既可以仅基于影像学诊断用作主要治疗，也可以在开颅术后用作辅助治疗。它能以最小的不良后遗症实现长期肿瘤控制。
