Traditional surgery is the effective treatment of disease. The last major cases reported operative mortality rate was four percent of a 36 per cent, with an average of 15%. Recently, with the level of diagnosis, cystic tumor vascular network weaving the mortality rate has been reduced to two percent a 5 percent, but the substantive vascular network texture of the cell death rate is still higher, at 36 percent. How to improve the texture of vascular network of treatment, complications and mortality is reduced majority of doctors pursuit of the goal. As vascular network woven by the cells of young vascular tissue and tumor cells, a clear boundary, so it is a good indication of the Gamma Knife treatment. Moreover, because about 20 percent of the vascular network weaving a tumor patients with Von HipPel - Lindan syndrome, conventional microsurgery unsuitable for such treatment of the vascular network weaving multiple tumor cells, and the small size of such tumors , Border-rich blood vessels and, therefore, is the ideal radiation treatment of primary target.
Gamma Knife treatment indications
cystic vascular network of cells should be preferred woven surgical treatment, such as the frail elderly patients can not tolerate surgery or brain tumors in areas important function of the risk of surgery, Gamma Knife and capsule feasible except for the treatment of liquid pumped.
small and medium-sized substantive vascular network of cells suitable for weaving Gamma Knife treatment.
For large vessels reticulocyte cell tumor, surgical excision is very difficult, consider points Gamma Knife treatment.
Gamma Knife dose
Niemela, such as in the reports, the first six cancer patients around the average radiation dose of 25. OGy, the remaining five cases surrounding the average dose of 10 Gy. One of them surrounding dose 25. OGy patients. He suggested that the tumor surrounding dose 10.0 1 15. OGy, effective control or substantial narrowing small and medium-sized vessels of reticulated cell tumor. Shanghai Gamma Knife Hospital were followed up for 17 cases, the tumor surrounding the average dose of 17. 6Gy, except one case of solid tumor is not brought under control, the other substantive tumors were well controlled. 10 cases of cancer did not increase or reduce the patients, of which eight cases of the implementation of the surrounding dose of 17.0 a 21. OGy. Their pathological results of that analysis, 15. OGy the radiation dose can not seem to kill tumor cells. To sum up, Gamma Knife treatment of vascular network texture of the surrounding cells should be 16 a dose of 20 Gy around suitable.
gamma knife treatment
Chandler, and other reports with radiation treatment of one case of blood vessels at the end of the fourth ventricle of reticulated cell tumor, tumor dose around 15. OGy, follow-up two years, no increase of cancer, patients with neurological symptoms. Niemela since 1978, such as a 1994 treatment of the 10 cases of reticulated cell tumor of blood vessels of patients, average age 48 years old, men and women Geban. Four patients have a more pronounced family history of VHL or the clinical manifestations, three cases of VHL patients in the surgical treatment of radiation found in the cerebral vascular network of multiple texture cell tumor. 10 cases of a total of 11 patients lesions, five for cystic; six for substantive, located in the cerebellum, the brain and on the saddle. Gamma knife after an average of 14 months, four tumor did not change; after 30 months, six tumor nodules reduced a tumor nodules in the Gamma Knife after 51 months in cystic change, Need surgical resection cyst. Shanghai Gamma Knife Hospital has 17 cases of vascular network of the texture of follow-up data, found that the substantive effect of small and medium-sized tumor treatment good, substantive case because of large tumor size large , of Gamma Knife After 18 months, to continue to increase due to cancer and cerebral edema and died. They found that the tumor with cystic change, especially change cystic greater, although the tumor completely control, but can not control the increase of cystic change.
At present, and the reticulated cells accompanied substantial part of a cystic change the mechanism is not clear, surgical resection of the substance after Nangqiang can disappear, suggesting that wall did not have active secretion, the surgical treatment of radiation exposure only when its end Festival can be part of. However, many integrated substantive part of the literature found that the tumor radiation treatment after surgery and can not terminate Nangqiang the formation, therefore, cystic vascular network of cells seems to be woven not suitable for gamma knife treatment. Beijing O Hoi Gamma Knife Centre has three cases of cystic intracranial blood vessels and tumor cells reticulocyte one case of cerebral vascular network of multiple substantive texture of the treatment of experience. One case of patients with cystic against substantive nodules for Gamma Knife treatment kit with the exception of pumping, patients with clinical symptoms disappear, one year after the review, the tumor nodules were slightly reduced, Nangqiang narrow 70 percent; two cases did not visit Puncture treatment, because of clinical symptoms did not improve tumor control are not satisfied with the final line treatment; one case of cerebral vascular multiple substantive reticulocyte cell tumor, the gamma knife treatment of multiple up significantly in the narrow or disappear.
Lessons learned, for cystic vascular network of cells should be woven Gamma Knife plus capsule for the treatment of liquid pumped addition, we believe that in patients with the best under the permission of the first gamma knife treatment, and then to puncture extract of stereotactic . Because the cysts will open the surrounding normal brain tissue, with the target distance increases, which can then be used larger doses of radiation stove, and thereby improve the treatment of cancer than the rate of local control. Of course, if the obvious symptoms in patients with high intracranial pressure, or affect the brain stem, and other important functions, should be directed out of first, then to ease the symptoms of Gamma Knife treatment better.
