Spiegelmann Roberto, Nissim Ouzi, Menhel Janna, Alezra Dror, Pfeffer M Raphael
Stereotactic Radiosurgery Unit, Department of Neurosurgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel.
Neurosurgery. 2002 Dec;51(6):1373-79; discussion 1379-80.
A retrospective study to evaluate the efficacy and side effects of linear accelerator radiosurgery in the treatment of cavernous sinus meningiomas.
Between 1993 and 2001, 42 patients with meningiomas involving the cavernous sinus underwent linear accelerator radiosurgery at our institution. A mean radiation dose of 14 Gy was delivered to the tumor margin. The median tumor volume was 8.2 cm3 (mean, 8.4 cm3). Median follow-up was 36 months (mean, 38 mo).
Control of tumor growth was achieved in 97.5% of the patients. There was no mortality or permanent extraocular motor or pituitary dysfunction. Treatment-related complications included new trigeminal neuropathy in 4.7% and a new visual field defect in 2.8%. Two patients required shunt placement after developing hydrocephalus. One patient with symptomatic temporal lobe edema underwent partial excision of the tumor. Improvement of existing cranial neuropathies was noted in 29% of affected trigeminal nerves, in 22% of oculomotor nerves, and in 13% of Cranial Nerves IV and VI.
This study indicates that linear accelerator radiosurgery can achieve a high control rate of meningiomas involving the cavernous sinus with no mortality and a low incidence of morbidity.
进行一项回顾性研究，以评估直线加速器放射外科治疗海绵窦脑膜瘤的疗效和副作用。
1993年至2001年间，42例海绵窦脑膜瘤患者在我院接受直线加速器放射外科治疗。肿瘤边缘的平均辐射剂量为14 Gy。肿瘤体积中位数为8.2 cm³（平均8.4 cm³）。中位随访时间为36个月（平均38个月）。
97.5%的患者肿瘤生长得到控制。无死亡病例，也无永久性眼外肌运动或垂体功能障碍。与治疗相关的并发症包括4.7%的患者出现新的三叉神经病变，2.8%的患者出现新的视野缺损。两名患者在发生脑积水后需要进行分流术。一名有症状性颞叶水肿的患者接受了肿瘤部分切除术。29%的受累三叉神经、22%的动眼神经以及13%的滑车神经和展神经现有神经病变得到改善。
本研究表明，直线加速器放射外科治疗海绵窦脑膜瘤可实现高控制率，无死亡病例，发病率低。
