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Neurological Surgery No Shinkei Geka Volume 24, Issue 3 （March 1996）

Neurological Surgery 脳神経外科 24巻3号（1996年3月発行）

Japanese English

研究

悪性頭蓋底腫瘍に対するガンマナイフ治療の効果について The results of gamma knife radiosurgery for malignant skull base tumors 田中孝幸 ¹ , 小林達也 ¹ , 木田義久 ¹ , 雄山博文 ¹ , 丹羽政宏 ¹ Takayuki TANAKA ¹ , Tatsuya KOBAYASHI ¹ , Yoshihisa KIDA ¹ , Hirofumi OYAMA ¹ , Masahiro NIWA ¹ ¹小牧市民病院脳神経外科 ¹Department of Neurosurgery, Komaki City Hospital キーワード： skull base tumor , radiosurgery , gamma knife Keyword: skull base tumor , radiosurgery , gamma knife pp.235-239

発行日 1996年3月10日 Published Date 1996/3/10

DOI https://doi.org/10.11477/mf.1436901172

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Abstract 文献概要
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I．はじめに

　当院では，1991年5月より1995年6月までに950例の患者をガンマナイフ手術により治療してきた．この中，5カ月以上追跡調査できた悪性頭蓋底腫瘍は19例（2.0％）ある．これまでに，悪性頭蓋底腫瘍として，脊索腫に対するradiosurgeryの治療成績^1,2,12）や上咽頭癌に対するガンマナイフ手術の症例報告^9,11）についての文献は少数あるが，種々の悪性頭蓋底腫瘍に対するガンマナイフ手術の治療成績をまとめた報告はなく，今回その観点より検討を加えることとした．

The results of gamma knife radiosurgery for malig-nant skull base tumors were analyzed using repeated magnetic resonance imagings and neurological ex-aminations.

Nineteen malignant skull base tumors were treated and followed up for 22.3 months (5-40 months) using MR imagings. The mean age was 54.4 years old (ranging from 16-85). Ten were male and 9 were female. Prior to the radiosurgery, removal of the tumors in 17 cases, conventional radiation therapy in 7, and chemotheapy in 4 etc. were performed. The patho-logical diagnoses were chordoma in 6 cases, metastatic tumors in 5, epipharyngeal carcinoma in 2, adenoid cys-tic carcinoma in 2, and others in 4. The locations of tumors were the clivus in 8, the parasellar region in 5, the epipharynx in 2, the paranasal sinus in 2, C-P angle in 1, and intraorbital region in 1 (14 were intracranial and 5 were extracranial). The mean diameter of the tumor was 33.5mm. The mean maximum dose was 26.8Gy and the mean marginal dose was 12.9Gy during treatment.

Repeated MR imagings revealed decrease of tumor size in 12 cases, no change in 1, and increase of tumor size in 5 (unknown in 1). Follow-up neurological ex-aminations showed improvement in 3 cases, no change in 9, and deterioration in 7. There were 11 deaths dur-ing a mean follow-up period of 17.8 months (5-32 months) and another 8 cases are alive for a mean fol-low-up of 30.5 months (20-40 months) after the radiosurgery. Although the tumor size was large at the time of treatment, the results of gamma knife radiosurgery were promising.

Considering the quality of life of patients with malig-nant skull base tumors, it is emphasized that gamma knife treatment is the method of choice compared with radical removal of the tumors.