Gamma knife surgery in the management of orbital tumors

【作者】 徐德生；

【机构】 天津医科大学第二医院神经外科暨伽玛刀中心；

【摘要】 <正>Object The authors evaluate their results when using gamma knife surgery(GKS) in the management of patients with orbital tumors.Methods This is a retrospective clinical evaluation of 325 patients with orbital tumors treated with GKS from Sep 1995 through Oct 2008.The series included 140 male and 185 female patients with a mean age of 37.1 17.6 years(range 1.7 85 years).The diagnoses were based on pathological analyses in 153 patients,confirmed by characteristic clinical and radiographic findings in 127 patients,and uncertain in the remaining 45.There were 76 meningioma,54 cavernous hemangioma,38 epithelial tumors of the lacrimal gland,32 venous angioma,23 schwannoma,18 malignant choroidal melanoma,9 optic nerve glioma,9 metastases,8 pseudotumor of the orbit,6 capillary hemangioma,3 retinoblastoma,3 fibromatosis and 1 lipoma.The tumor margin dose ranged from 8 to 40Gy.The median target volume was 5.8 cm~3(range 0.03 35.6 cm~3).Results At a median follow - up period of 35.7 16.2 months(range,12 to 114 months),tumor shrinkage was observed in 213 patients(65.54%),and the tumor size was stable in 91(28%).Persistent neuroimaging demonstrated evidence of progression in only 21 patients(6.46%):13 underwent repeated GKS and 8 referred for surgical treatment Visual acuity was preserved in 239 patients.132 patients experienced some degree of visual sight improvement.Deterioration of visual acuity was found in 23 of 262 patients who had useful visual sight before treatment 34 patients (10.46%) experienced transient conjunctival edema,no other serious acute side effect was observed.Conclusion Gamma knife provides an effective management strategy in patients with orbital tumors;it achives excellent neurological founction preservation and few treatment - related complications.更多还原

【Abstract】 Object The authors evaluate their results when using gamma knife surgery(GKS) in the management of patients with orbital tumors.Methods This is a retrospective clinical evaluation of 325 patients with orbital tumors treated with GKS from Sep 1995 through Oct 2008.The series included 140 male and 185 female patients with a mean age of 37.1 17.6 years(range 1.7 85 years).The diagnoses were based on pathological analyses in 153 patients,confirmed by characteristic clinical and radiographic findings in 127 patients,and uncertain in the remaining 45.There were 76 meningioma,54 cavernous hemangioma,38 epithelial tumors of the lacrimal gland,32 venous angioma,23 schwannoma,18 malignant choroidal melanoma,9 optic nerve glioma,9 metastases,8 pseudotumor of the orbit,6 capillary hemangioma,3 retinoblastoma,3 fibromatosis and 1 lipoma.The tumor margin dose ranged from 8 to 40Gy.The median target volume was 5.8 cm~3(range 0.03 35.6 cm~3).Results At a median follow - up period of 35.7 16.2 months(range,12 to 114 months),tumor shrinkage was observed in 213 patients(65.54%),and the tumor size was stable in 91(28%).Persistent neuroimaging demonstrated evidence of progression in only 21 patients(6.46%):13 underwent repeated GKS and 8 referred for surgical treatment Visual acuity was preserved in 239 patients.132 patients experienced some degree of visual sight improvement.Deterioration of visual acuity was found in 23 of 262 patients who had useful visual sight before treatment 34 patients (10.46%) experienced transient conjunctival edema,no other serious acute side effect was observed.Conclusion Gamma knife provides an effective management strategy in patients with orbital tumors;it achives excellent neurological founction preservation and few treatment - related complications.更多还原