Meijer O W, Wolbers J G, Baayen J C, Slotman B J
Department of Radiation Oncology, University Hospital VU-Ziekenhuis, Amsterdam, The Netherlands.
Int J Radiat Oncol Biol Phys. 2000 Jan 1;46(1):45-9. doi: 10.1016/s0360-3016(99)00363-6.
To prospectively assess the local control and toxicity rate in acoustic neuroma patients treated with linear accelerator-based radiosurgery and fractionated stereotactic radiation therapy.
We evaluated 37 consecutive patients treated with stereotactic radiation therapy for acoustic neuroma. All patients had progressive tumors, progressive symptoms, or both. Mean tumor diameter was 2.3 cm (range 0.8-3.3) on magnetic resonance (MR) scan. Dentate patients were given a dose of 5x4 Gy or 5x5 Gy and edentate patients were given a dose of 1x10 Gy or 1x12.50 Gy prescribed to the 80% isodose. All patients were treated with a single isocenter.
With a mean follow-up period of 25 months (range 12-61), the actuarial local control rate at 5 years was 91% (only 1 patient failed). The actuarial rate of hearing preservation at 5 years was 66% in previously-hearing patients. The actuarial rate of freedom from trigeminal nerve toxicity was 97% at 5 years. No patient developed facial nerve toxicity or other complications.
In this unselected series, fractionated stereotactic radiation therapy and linear accelerator-based radiosurgery give excellent local control in acoustic neuroma. It combines a high rate of preservation of hearing with a very low rate of other toxicity, although follow-up is relatively short.
前瞻性评估接受基于直线加速器的放射外科手术和分次立体定向放射治疗的听神经瘤患者的局部控制率和毒性率。
我们评估了37例连续接受立体定向放射治疗的听神经瘤患者。所有患者均有肿瘤进展、症状进展或两者皆有。磁共振（MR）扫描显示肿瘤平均直径为2.3 cm（范围0.8 - 3.3）。有牙患者给予5×4 Gy或5×5 Gy的剂量，无牙患者给予1×10 Gy或1×12.50 Gy的剂量，处方剂量为80%等剂量线。所有患者均采用单一等中心进行治疗。
平均随访期为25个月（范围12 - 61个月），5年时精算局部控制率为91%（仅1例患者失败）。5年时，既往有听力的患者听力保留精算率为66%。5年时三叉神经毒性-free精算率为97%。无患者发生面神经毒性或其他并发症。
在这个未进行选择的系列研究中，分次立体定向放射治疗和基于直线加速器的放射外科手术在听神经瘤中能实现出色的局部控制。尽管随访时间相对较短，但它将高听力保留率与极低的其他毒性率相结合。
