Lim Michael, Gibbs Iris C, Adler John R, Chang Steven D
Department of Neurosurgery, Stanford University Medical Center, Stanford, California, USA.
Neurosurg Focus. 2004 Aug 15;17(2):E11. doi: 10.3171/foc.2004.17.2.11.
Since the mid-1990s the use of radiosurgery for glomus jugulare tumors has grown in popularity. Despite its increased use, follow-up periods for radiosurgery are short and the numbers of patients reported are small. To add to the available information, the authors report their experience with the application of linear accelerator (LINAC) or CyberKnife modalities in 13 patients with 16 tumors.
All patients were treated with frame-based LINAC or CyberKnife radiosurgery, with doses ranging from 1400 to 2700 cGy. Patients were retrospectively assessed for posttreatment side effects, which included hearing loss, tongue weakness, and vocal hoarseness. The patients' most recent magnetic resonance (MR) images were also assessed for changes in tumor size. The median follow-up duration was 41 months and the mean follow-up period was 60 months. All tumors remained stable or decreased in size on follow-up MR images. All patients had stable neurological symptoms, and one experienced transient ipsilateral tongue weakness and hearing loss, both of which subsequently resolved. One patient experienced transient ipsilateral vocal cord paresis; however, this individual had received previous external-beam radiation therapy.
The authors' findings continue to support radiosurgery as an effective and safe method of treatment for glomus jugulare tumors that results in low rates of morbidity.
自20世纪90年代中期以来,放射外科治疗颈静脉球瘤的应用越来越普遍。尽管其使用增加,但放射外科的随访期较短,且报告的患者数量较少。为补充现有信息,作者报告了他们应用直线加速器(LINAC)或射波刀治疗13例患者共16个肿瘤的经验。
所有患者均接受基于框架的LINAC或射波刀放射外科治疗,剂量范围为1400至2700 cGy。对患者进行回顾性评估,观察治疗后的副作用,包括听力丧失、舌肌无力和声音嘶哑。还评估了患者最近的磁共振(MR)图像,以观察肿瘤大小的变化。中位随访时间为41个月,平均随访期为60个月。随访MR图像显示所有肿瘤大小保持稳定或缩小。所有患者的神经症状稳定,1例患者出现短暂的同侧舌肌无力和听力丧失,但随后均恢复。1例患者出现短暂的同侧声带麻痹;然而,该患者此前接受过外照射放疗。
作者的研究结果继续支持放射外科作为治疗颈静脉球瘤的一种有效且安全的方法,其发病率较低。