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Neurological Surgery No Shinkei Geka Volume 28, Issue 5 （May 2000）

Neurological Surgery 脳神経外科 28巻5号（2000年5月発行）

Japanese English

研究

頭蓋底髄膜腫に対するガンマナイフ治療—その治療成績と患者アンケート Gamma Knife Radiosurgery for Skull Base Meningiomas : the treatment results and patient satisfaction expressed in answers to a questionnaire 岩井謙育 ¹ , 山中一浩 ¹ , 中島英樹 ¹ , 安井敏裕 ¹ , 岸廣成 ¹ Yoshiyasu IWAI ¹ , Kazuhiro YAMANAKA ¹ , Hideki NAKAJIMA ¹ , Toshihiro YASUI ¹ , Hiroshige KISHI ¹ ¹大阪市立総合医療センター脳神経外科 ¹Department of Neurosurgery, Osaka City General Hospital キーワード： meningioma , skull base , radiosurgery , tumor Keyword: meningioma , skull base , radiosurgery , tumor pp.411-415

発行日 2000年5月10日 Published Date 2000/5/10

DOI https://doi.org/10.11477/mf.1436901885

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Abstract 文献概要
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I．はじめに

　頭蓋底髄膜腫の手術成績は，手術手技，手術アプローチの進歩により改善しているが，なお高い合併症が報告されている^{1,2,11,13,14）}．一方radio-surgeryは，髄膜腫に対して，低い合併症で80から100％の腫瘍増大抑制効果が報告されている^{3-8,10,12,15,16）}．われわれは，当院にて経験した頭蓋底髄膜腫に対するガンマナイフの治療成績を検討し，患者へのアンケートも行い患者の治療に対する満足度も検討した．

Skull base meningiomas can be treated by radiosurgery with low morbidity. We evaluated the effective-ness of gamma knife radiosurgery for skull base meningiomas. We also evaluated patient satisfaction through answers to a questionnaire.

We treated 77 patients of skull base meningiomas using gamma knife radiosurgery from January 1994 to June 1998. Among these patients, 73 patients were able to be followed up from 6 to 60 months (average 25 months). The diagnosis was made by operations on 39 patients (53%), and on magnetic resonance imag-ings in 34 patients (47%). 21 patients (28.7%) had residual tumors after operations and 18 patients (24.3%) had recurrence after operations. 40% of neurological deficits occurred after previous operations and 20% of the patients were asymptomatic. The locations of the tumors were mainly the cavernous sinus region in 35 patients and the petroclival region in 20 patients. The tumor sizes were 8.6 to 58.3 mm (average 24.7 mm) and five cases of tumors with a mean diameter above 40 mm were treated by two-staged radiosurgery. Treatment volume was 0.3 to 31 ml (average 9.8 ml). The treatment dose was 8 to 16 Gy (average 11.2 Gy) at the tumor margin. The tumor decreased in size in 50 patients (68%) and was unchanged in 20 pa-tients (28%) and we were able to achieve 96% tumor growth control. The clinical symptoms improved in 22 patients (30.1%) and were unchanged in 47 patients (64.4%) and only 4 patients (5.5%) showed de-terioration. 50 patients (68%) felt clinical improvement and only 3 patients (4%) sensed deterioration. 58 patients (79%) were able to continue their previous work.

Gamma knife radiosurgery has a very low morbidity rate and enables good tumor control, and patients with skull base meningiomas express satisfaction with the treatment results.