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目的探讨伽玛刀剂量分割治疗脑深部较大胶质瘤的临床疗效及反应。方法OUR-旋转式伽玛刀剂量分割治疗脑深部较大(d>3cm)胶质瘤64例,均安装立体定位架可重复安装配件,每天治疗一次,连续进行2～5d,每次周边剂量4.5～10Gy,每次治疗结束时摘除定位架,下次治疗前重复原位安装。结果随访6～24个月,随访的57例中51例在2个月内缓解症状,影像复查的31例中25例肿瘤控制增长。但在随访期内临床症状复发14例,影像肿瘤复发4例。57例中治疗无效、病情加重、死亡6例。结论对于脑深部较大胶质瘤伽玛刀剂量分割治疗疗效明显,可缓解症状、提高生活质量,有望取代手术治疗成为首选;为防止肿瘤复发,应结合外放疗和化疗,必要时手术。
Objective To investigate the clinical efficacy and response of Gamma Knife Dose Slicing in the treatment of large glioma in deep brain. Methods OUR-rotary gamma knife dose division treatment of deep brain deep (d> 3cm) glioma in 64 cases, are equipped with stereotactic reusable mounting accessories, once a day for 2 ~ 5d, each peripheral dose 4.5 ~ 10Gy, remove the positioning frame at the end of each treatment, repeat the original installation before the next treatment. Results The follow-up ranged from 6 to 24 months. Among 57 follow-up cases, 51 patients relieved the symptoms within 2 months. Twenty-five of the 31 patients underwent image review. However, in the follow-up period of clinical symptoms in 14 cases of recurrence, imaging tumor recurrence in 4 cases. 57 cases of ineffective treatment, exacerbations, 6 deaths. Conclusions The treatment of large segment of gliomas with large dose of Gamma Knife can effectively relieve the symptoms and improve the quality of life. It is expected to replace the surgical treatment as the first choice. In order to prevent tumor recurrence, external radiotherapy and chemotherapy should be combined with surgery if necessary.