伽玛刀放射外科治疗眼眶海绵状血管瘤

摘要

目的 总结评价眼眶海绵状血管瘤伽玛刀放射外科治疗的中长期疗效.方法 回顾性分析45例采用Leksell伽玛刀治疗的眼眶海绵状血管瘤病人的临床资料,其中累及眶尖部病变36例,眼眶前中部9例.边缘剂量10.0～20.0 Gy,中位剂量12.0 Gy.结果 病人在伽玛刀治疗后均未出现新的脑神经功能受损症状,突眼症状缓解23例,视力提升22例,4例出现病侧一过性球结膜水肿.45例病人随访18～120个月,平均(28.2±9.4)个月,复查MRI和(或)CT显示病灶体积缩小41例(91.1％),无明显变化4例(8.9％).随访期内无复发及再手术病例.结论 伽玛刀治疗眼眶海绵状血管瘤可长期控制肿瘤生长,又取得较高的神经功能保留率,并发症罕见,可作为眼眶海绵状血管瘤的主要治疗方法之一,值得推广.%Objective To summarize and evaluate the medium- and long-term efficacy of Gamma knife radiosurgery for orbital cavernous hemangiomas (OCH). Methods Clinical data of 45 OCH patients who received Leksell gamma knife therapy were analyzed retrospectively, including 36 lesions located in the orbital apex and 9 in the middle and anterior parts of orbit. The prescription peripheral dose arranged from 10.0 to 20.0 Gy with the median dose of 12.0 Gy. Results There was no new symptom related to cranial nerve dysfunction after gamma knife therapy. Exophthalmos was improved in 23 patients, visual acuity in 22 and transient chemosis occurred in 4. All the patients were followed up for 18 to 120 months with a mean period of 28.2 ± 9.4 months. MRI and/or CT reexamination showed that the lesion volume shrank in 41 patients (91.1％) and remained unchange in 4 (8.9％). No recurrence and reoperation occurred in all patients. Conclusions Gamma knife therapy can control the tumor growth for long term and achieve excellent neurological function preservation with rare complication, thus can be used as one of the main treatments for OCH and worthy to be popularized.