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目的:评估伽玛刀治疗残留和复发的颅底脊索瘤的疗效及安全性。方法:对27例残留和复发颅底脊索瘤进行伽玛刀治疗。肿瘤治疗平均周边剂量为11.8±2.1Gy(8-15Gy),以40%~55%等剂量曲线覆盖病灶。伽玛刀治疗后定期进行随访观察,统计分析肿瘤控制情况及并发症发生情况。结果:共24例患者获得随访资料,平均随访27.8±7.9个月。15例(62.5%)患者临床症状获得不同程度改善,8例无明显变化(33.3%),1例加重(4.2%)。24例患者共接受伽玛刀治疗31次。至随访结束,共有3人死亡。未观察到与伽玛刀治疗直接相关的近远期严重并发症。结论:对于手术和常规放射治疗后残留或复发的脊索瘤,伽玛刀治疗是一种安全、有效的放射治疗手段,可以显著改善患者预后和生活质量。
Objective: To assess the efficacy and safety of gamma knife in the treatment of residual and recurrent skull base chordoma. Methods: 27 cases of residual and recurrent skull base chordoma were treated with gamma knife. The average peripheral dose of tumor treatment was 11.8 ± 2.1 Gy (8-15 Gy), and the lesion was covered with isodose curve of 40% -55%. Gamma Knife regular follow-up observation after treatment, statistical analysis of tumor control and complications. Results: A total of 24 patients were followed up for a mean of 27.8 ± 7.9 months. The clinical symptoms of 15 patients (62.5%) were improved to some extent, with no significant change in 8 cases (33.3%) and exacerbation in 1 case (4.2%). Twenty-four patients received gamma knife treatment for 31 times. At the end of follow-up, a total of 3 people died. No near-term serious complications were found directly related to gamma knife treatment. Conclusion: Gamma knife treatment is a safe and effective means of radiotherapy for residual or recurrent chordoma after surgery and conventional radiotherapy, which can significantly improve prognosis and quality of life.