Stereotactic Gamma Knife Radiosurgery for Vestibular Schwannomas: Trade-offs between Total Tumor Resection and Postoperative Sequelae

伽瑪刀治療在前庭神經鞘瘤腫全切除及術後後遺症之抉擇

陳淑賢(Shu-Hsien Chen) ； 蔡佩晏(Pei-Yien Tsai) ； 蔡燕慧(Yen-Hui Tsai) ； 林知瑩(Chih-Ying Lin)

《長榮大學學報》 16卷1期 (2012/06) Pp. 77-85

https://doi.org/10.30115/JCJCU.201206.0005

摘要

目的：對於前庭神經鞘瘤顱術後有高風險後遺症病人在選擇治療方式上目前以伽瑪刀放射性手術為最佳治療方式，伽瑪刀放射性手術的好處包括神經功能保存和顯著降低復發風險。這種立體定位放射性手術與放射治療並不完全切除腫瘤，而是破壞腫瘤細胞的DNA結構，導致腫瘤細胞失去能力重新生長。材料與方法：本研究對象以手術後順利出院病人，術後電腦斷層掃描（CT）或磁共振成像（MRI）的診斷為前庭神經鞘瘤病人。結果：使用伽瑪刀放射性手術病人降低術後後遺症與神經功能損傷。結論：前庭神經鞘瘤病人治療方法其中一種為伽瑪刀放射性手術，併發症為腦積水，伽瑪刀放射性手術適應症病人腫瘤最大直徑在小於2.5公分以下以及其高風險老年患者以及在復發性腫瘤及殘餘性生長腫瘤。在伽瑪刀放射性手術後持續密切監測及預防腦損傷症狀。

關鍵字

伽瑪刀放射性手術 ； 前庭神經鞘瘤 ； 神經功能 ； 電腦斷層

並列摘要

Since schwannonmas are abnormal nerve sheath neoplasms that may originate from any cranial, peripheral or autonomic nerves. In this article we object to clear the differences between the traditional operation and Gamma knife radiosurgery where the schwannomas are large enough. We might trade off both complete remove with nerve injury and part resection with nerve reservation. We find that Gamma knife radiosurgery is currently an optimal treatment option for patients with higher residual intracranial tumors. The benefits include nerve function preservation and significantly decreased risk of recurrence. This stereotactic radio surgery works does not remove the tumor completely, rather it distorts the DNA of tumor cell and causes these cell s to lose their ability to re-grow. We surveyed patients with an uneventful postoperative period who were usually given the option to be discharged within a postoperative day after a contrast enhanced computed tomography or magnetic resonance imaging of the vestibular schwannomas. This stud y observed some cases of postoperative sequelae and examines the trade-off between such damage and nerve function preservation on patients by using Gamma knife radiosurgery.

並列關鍵字

Gamma Knife Radiosurgery ； Residual Intracranial Tumors ； Nerve Function Preservation ； Computed Tomography

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