Stafford S L, Pollock B E, Foote R L, Gorman D A, Nelson D F, Schomberg P J
Division of Radiation Oncology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
Cancer. 2000 Feb 15;88(4):870-5.
Patients with recurrent intracranial ependymomas were evaluated to assess local control, overall survival, and complications from stereotactic radiosurgery (SRS).
Twelve patients (with a total of 17 tumors) with recurrent ependymoma underwent SRS. Local failure was defined as tumor progression within the prescription isodose volume, and marginal failure was defined as tumor progression adjacent to the SRS prescription isodose volume. Tumor progression away from the prescription volume was considered distant failure. Eleven of the 12 patients had undergone previous resection and external beam radiation therapy (46-56 Grays [Gy]; median, 54 Gy) before radiosurgery, and 1 patient had failure after complete resection alone. Age at SRS ranged from 5-56 years (median, 29 years). Three patients were female. The marginal tumor dose was 12-24 Gy (median, 18 Gy). One to 14 isocenters (median, 4 isocenters) were utilized to irradiate volumes of 0.3-15.5 cm(3) (median, 3.2 cm(3)).
The duration of follow-up ranged from 2.5-60 months (median, 22.5 months). The median overall survival after SRS was 3.4 years (range, 1.4-5 years). In-field local control was achieved in 14 of the 17 tumor sites and estimated 3-year local control was 68%. There were two in-field failures and one marginal failure. Distant failure occurred in two patients. Two patients developed treatment-related complications after SRS.
SRS provides good local tumor control for patients with recurrent intracranial ependymoma and may have a favorable impact on survival. SRS should be evaluated more extensively in the initial treatment of patients with ependymoma to minimize local failure after surgical management.
对复发性颅内室管膜瘤患者进行评估，以评估立体定向放射外科治疗（SRS）的局部控制、总生存期和并发症。
12例（共17个肿瘤）复发性室管膜瘤患者接受了SRS治疗。局部失败定义为肿瘤在处方等剂量体积内进展，边缘失败定义为肿瘤在SRS处方等剂量体积相邻处进展。远离处方体积的肿瘤进展被视为远处失败。12例患者中有11例在放射外科治疗前曾接受过手术切除和外照射放疗（46 - 56格雷[Gy]；中位数，54 Gy），1例患者仅在完全切除后出现复发。接受SRS治疗时的年龄范围为5 - 56岁（中位数，29岁）。3例为女性。边缘肿瘤剂量为12 - 24 Gy（中位数，18 Gy）。使用1至14个等中心（中位数，4个等中心）照射体积为0.3 - 15.5 cm³（中位数，3.2 cm³）的肿瘤。
随访时间为2.5 - 60个月（中位数，22.5个月）。SRS治疗后的中位总生存期为3.4年（范围，1.4 - 5年）。17个肿瘤部位中的14个实现了野内局部控制，估计3年局部控制率为68%。有2例野内失败和1例边缘失败。2例患者出现远处失败。2例患者在SRS治疗后出现与治疗相关的并发症。
SRS为复发性颅内室管膜瘤患者提供了良好的局部肿瘤控制，可能对生存期有有利影响。在室管膜瘤患者的初始治疗中应更广泛地评估SRS，以尽量减少手术治疗后的局部失败。
