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目的 总结对脑胶质瘤患者X刀治疗的临床效果。方法 我院用X刀治疗脑胶质瘤 5 0例 ,其中分次X刀治疗 4例。星形细胞瘤 48例 ,髓母细胞瘤 2例。X刀周边剂量 14.14～ 2 8.5 0Gy ,平均 (2 1.17± 3.79)Gy ,一般以 70 %～ 90 %等剂量线覆盖肿瘤边缘。 43例经 6～ 5 4个月随访。 结果 影像学检查发现肿瘤消失 8例 ,缩小 11例 ,大小不变 13例 ,增大 11例。肿瘤坏死 2 1例 ,囊性变 8例 ,环状强化 9例 ,肿瘤暂时性反应性肿大6例 ,脑水肿 10例 ,脑坏死 2例。结论 对手术难以切除、体积小的胶质瘤X刀治疗安全有效 ,X刀术后脑水肿较常见 ,分次X刀治疗有可能降低其发生率 ,术后出现的肿瘤反应性肿大和脑坏死需要与肿瘤进展鉴别
Objective To summarize the clinical effect of X knife treatment on patients with glioma. Methods Fifty cases of glioma were treated with X knife in our hospital. Four cases were treated by X knife. 48 cases of astrocytoma, medulloblastoma in 2 cases. X knife peripheral dose 14.14 ~ 2 8.5 0Gy, an average (2 1.17 ± 3.79) Gy, generally 70% to 90% of the dose line covering the tumor margin. 43 cases were followed up for 6 ~ 54 months. Results Imaging examination found that the tumor disappeared in 8 cases, reduced in 11 cases, the same size in 13 cases, an increase of 11 cases. There were 21 cases of tumor necrosis, 8 cases of cystic degeneration, 9 cases of ring enhancement, 6 cases of transient reaction enlargement of tumor, 10 cases of cerebral edema and 2 cases of cerebral necrosis. Conclusions It is safe and effective to treat X-knife gliomas with small size, X-knife post-operative brain edema is more common, and X-knife treatment may reduce the incidence of postoperative tumor reactivity swelling and cerebral necrosis Need to identify with the progress of the tumor