Chernov M, Hayashi M, Izawa M, Nakaya K, Ono Y, Usukura M, Yoshida S, Kato K, Muragaki Y, Nakamura R, Iseki H, Hori T, Takakura K
International Research and Educational Institute for Integrated Medical Sciences (IREIIMS), Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.
Minim Invasive Neurosurg. 2007 Aug;50(4):233-8. doi: 10.1055/s-2007-985891.
Metabolic characteristics of intracranial metastases, detected with proton magnetic resonance spectroscopy (1H-MRS) have known associations with clinical predictors of tumor response to radiosurgery. Therefore, it can be suspected that the metabolic profile of the neoplasm by itself might have some prognostic significance for the outcome after irradiation. Twenty-six intracranial metastases, which underwent metabolic evaluation with single-voxel 1H-MRS before gamma knife radiosurgery (GKR) and were followed for at least 3 months after treatment, were selected for retrospective analysis. The tumors most frequently originated from the lungs (9 cases), breast (7 cases), colon and rectum (5 cases). The average volume of the investigated intracranial neoplasm was 5.4+/-2.0 mL. The average marginal irradiation dose was 18.6+/-2.3 Gy. The mean follow-up after GKR constituted 8.0+/-5.5 months. Tumor response to GKR was identified in 13 cases on average 2.2+/-1.8 months after treatment. Local recurrence was marked in 10 cases on average 8.7+/-4.1 months after treatment. None of the investigated 1H-MRS metabolic parameters of intracranial metastases showed a statistically significant association with the outcome after GKR. The negative results of the present study make doubtful the predictive value of metabolic characteristics of intracranial metastases, detected with single-voxel 1H-MRS, for the outcome after radiosurgery.
通过质子磁共振波谱(1H-MRS)检测到的颅内转移瘤的代谢特征与肿瘤对放射外科治疗反应的临床预测指标存在已知关联。因此,可以推测肿瘤自身的代谢谱可能对放疗后的预后具有一定的预后意义。本研究选取了26例颅内转移瘤,这些病例在伽玛刀放射外科治疗(GKR)前接受了单体素1H-MRS代谢评估,并在治疗后至少随访3个月,进行回顾性分析。肿瘤最常见的原发部位为肺(9例)、乳腺(7例)、结肠和直肠(5例)。所研究的颅内肿瘤平均体积为5.4±2.0 mL。平均边缘照射剂量为18.6±2.3 Gy。GKR后的平均随访时间为8.0±5.5个月。平均在治疗后2.2±1.8个月确定13例肿瘤对GKR有反应。平均在治疗后8.7±4.1个月有10例出现局部复发。所研究的颅内转移瘤的1H-MRS代谢参数均未显示与GKR后的结果存在统计学显著关联。本研究的阴性结果使通过单体素1H-MRS检测到的颅内转移瘤代谢特征对放射外科治疗后结果的预测价值受到质疑。