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关键词：立体定向；放射性核素；颅咽管瘤
【摘要】 目的 研究CT引导立体定向放射性核素内放射治疗颅咽管瘤的有效性和安全性。方法 采用CT引导立体定向技术对300例颅咽管瘤进行了385次瘤内置入核素内放疗，并进行了随访观察。其中男180例，女120例，平均年龄30.5岁。全部病例均有视路受损症状。CT或MRI检查囊性肿瘤175例，实体性肿瘤40例，实体与囊腔并存85例。结果 无手术死亡及严重并发症。术后250例随访6个月至8年，平均4年：肿瘤消失180例(72%)；肿瘤显著缩小(>80%)30例(12%)；肿瘤缩小50%左右20例(8%)；肿瘤增大(主要为实体性)16例(6.4%)；死亡4例(1.6%)。结论 立体定向瘤内放射性核素间质内照射是治疗颅咽管瘤的一种有效方法；纯Beta射线源P-32和Y-90其穿透能力短易于运送与防护是理想的放射源；囊壁的照射剂量以200～250Gy为好。
Stereotactic intratumourirradiation with nuclide for craniopharyngio mas
LIU Zonghui, LI Shiyue, Yu Xin, et al. Navy GeneralHospital of PLA, Beijing 100037
【Abstract】 Objective To investigate theef ficiency and safety of CT guided stereotactic intratumour irradiation with nucl ide for craniopharyngiomas. Methods Stereotactic intratum our irradiation withinstillation of nuclide colloid was performed in 300 patien ts with craniopharyngiomas(alltogether 385 times). Of them, there are 180 males , 120 females with their ages rangedfrom 3 to 74 years old. All of them presen t ed with optic pathway impairment. CT or MRIscan showed cystic tumour in 175 cas es, solid and cystic in 85 and solid in 40. Results Therewere no severe complications and death related to the operation. 250 cases were fowlled-upfrom 6 monthes to 8 years(average 4 years): tumour disappeared in 1 8 0 cases(72%),markedly decreased in 30(12%), decreased less than half size in 20 (8%), increased of itssize in 16(6.4%) and death in 4(1.6%). Concl us ions Stereotacticintratumour irradiation with instillation of nucli de colloid is effective in the patientswith craniopharyngiomas. Beta-emitting i sotopes(p-32 and Y-90) are the preferred internalradiation source because of th eir limited penetration of the energy released and thegreater ease of handling. A calculated dose of 200～250Gy to the cyst wall is recommen-ded.
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