摘要目的 总结伽玛刀(γ刀)放射外科治疗听神经瘤的效果.方法 111例患者平均年龄为(46±18)岁,男性49例,女性62例;单侧病变97例,双侧14例;41例曾行手术治疗;75例γ刀治疗前存在有用听力;肿瘤直径为6～49 mm,平均21.3 mm;边缘剂量12～16 Gy,平均13.14 Gy,中心剂量24～32 Gy.结果 随访24～88个月,平均38.2个月;88例(79.3%)肿瘤缩小,18例(16.2%)大小无变化,5例(4.5%)肿瘤持续增大;治疗前存在有用听力的75例中21例(28%)听力下降;65例(86.7%)患者有用听力得到保留,其中19例(25.3%)较术前明显改善;26例(23.4%)出现患侧面瘫;7例(6.3%)出现三叉神经功能部分受损.结论 γ刀治疗听神经瘤有较高的肿瘤生长控制率和较高的神经功能保留率,是除显微外科手术外一种有效安全的治疗方法.

abstractsObjective To assess the results of gamma knife radiosurgery for vestibular schwan-nomas. Methods From July 1998 to July 2006, 111 cases of vestibular schwannomas were treaded with gamma knife. The 97 cases of them had solitary tumors; 14 cases with bilateral lesions. Prior resection had been performed in 41 patients. Facial nerve function was normal in 89 cases of the patients before ra-diosurgery, and 75 cases of them had serviceable heating. Prescription peripheral dose varied from 12 to 16 Gy(mean 13.14 Gy) ; the corresponding central dose was 24 to 32 Gy. The mean diameter of the tumor at radiosurgery was 21.3 mm (range, 6 to 49 mm). Results At a median follow up period of 38.2 months (range, 24 to 88 months), tumor shrinkage was observed in 88 cases (79.3%), and tumor size was sfable in 18 cases (16.2%). Only 6 eases (5.4%) showed persistent radiographic evi-dence of progression. Deterioration of hearing was found in 21 out of 75 cases who had useful hearing be-fore treatment,useful heating was preserved in 65 patients, 19 cases(25.7%) of which showed improve-ment in hearing. Conclusions Gamma knife radiosurgery prevents tumor growth, achieves excellent neurologic function preservation rates and few treatment -related comlications.