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目的 探讨囊性颅咽管瘤囊腔内放疗的有效性和安全性。方法 对 5 6例囊性颅咽管瘤行CT引导立体定向囊腔内放疗 ,根据个体化剂量设计分别置入 1～ 3次、2 .4～ 14 .8MBq不等胶体磷酸铬 (Cr3 2 Po4) ,并进行临床随访观察。结果 5 6例患者术后神经功能均很快出现不同程度的改善。随访 6个月至 9年 ,49例视力、视野障碍中 ,45例获得逐渐改善 ,4例恶化 ,偏瘫 3例恢复正常 ,所有内分泌功能障碍者均获得稳定或不同程度好转 ,复查CT或MR示 :5例瘤实质增大 (9% ) ,2例新的囊腔形成 ,1例导管在脑室内囊腔略缩小 ,囊腔完全消失 2 4例 (4 3 % ) ,囊腔明显缩小 (>80 % )2 4例 (86% )。无手术死亡及严重并发症。结论 立体定向囊腔内放疗是一种治疗囊性颅咽管瘤的安全而有效方法 ,放射剂量设计的个体化是提高治疗有效率的关键。
Objective To investigate the efficacy and safety of intracavitary radiotherapy for cystic craniopharyngioma. Methods Fifty-six cystic craniopharyngiomas were treated with CT-guided stereotactic radiotherapy. According to the individual dose design, 1 ~ 3 times and 2 ~ 4 ~ 14 .8MBq of colloidal chromium phosphate (Cr3 2 Po4 ), And clinical follow-up observation. Results The neurological function of 56 patients showed different degrees of improvement soon after operation. During the follow-up of 6 months to 9 years, 45 cases of visual acuity and visual field disorder got gradual improvement, 4 cases of aggravation and 3 cases of hemiplegia returned to normal. All of the patients with endocrine dysfunction got stable or improved to some extent. (P <0.05). In 5 cases, the tumor size increased substantially (9%), two new cysts were formed, one case had a slight shrinkage in the ventricular capsule, 24 cases (43%) disappeared completely, 80%) 24 cases (86%). No operative deaths and serious complications. Conclusion Stereotactic cystic cavity radiotherapy is a safe and effective method for the treatment of cystic craniopharyngioma. The individualization of radiation dose design is the key to improve the treatment efficiency.