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目的探讨伽玛刀治疗儿童下丘脑错构瘤(HH)的疗效。方法回顾性分析本院伽玛刀治疗中心1997-2006年使用OUR-XGD型旋转式伽玛刀治疗24例HH患儿的临床资料。男9例,女15例;首发症状为性早熟19例(79.17%),痴笑性癫5例(20.83%);有手术史6例(25%);诊断依据性早熟、痴笑性癫和MRI表现;症状随访24～91个月;影像学随访24～82个月;以肿瘤体积缩小和不变为肿瘤局部控制;治疗边缘剂量9～18Gy,中心剂量26.7～36.0Gy,等剂量曲线45%～55%。结果24例中症状改善6例(25%),痴笑性癫改善优于性早熟;19例肿瘤体积(79.17%)缩小,5例(20.83%)不变,肿瘤控制率达100%。无1例出现视神经损伤。结论伽玛刀可作为HH患儿主要治疗手段之一,对于术后残余肿瘤更具意义。
Objective To investigate the therapeutic effect of gamma knife on hypothalamic hamartoma (HH) in children. Methods A retrospective analysis of our hospital gamma knife treatment center 1997-2006 OUR-XGD rotary gamma knife in the treatment of 24 cases of HH in children with clinical data. There were 9 males and 15 females. The first symptom was 19 cases (79.17%) with precocious puberty, 5 cases (20.83%) with idiopathic delirium, 6 cases (25%) with operation history, And MRI findings; the symptoms were followed up for 24-91 months; the imaging was followed up for 24-82 months; the tumor volume was reduced and remained unchanged as the tumor local control; the treatment marginal dose was 9-18Gy and the central dose was 26.7-36.0 Gy. The isodose curve 45% ~ 55%. Results The improvement of symptoms in 24 cases was better than that in precocious puberty in 6 cases (25%). The tumor volume was reduced in 19 cases (79.17%), unchanged in 5 cases (20.83%) and the tumor control rate was 100%. No one had optic nerve injury. Conclusion Gamma knife can be used as one of the main treatment for children with HH, more meaningful for postoperative residual tumor.