Johnson Walter D, Loredo Lilia N, Slater Jerry D
Department of Neurosurgery, Loma Linda University, Loma Linda, California 92354, USA.
Neurosurg Focus. 2008;24(5):E2. doi: 10.3171/FOC/2008/24/5/E2.
Historically, radiation therapy has been used extensively in the treatment of malignant and aggressive intracranial tumors, and the importance of its role has been repeatedly verified by prolonged patient survival rates and increased tumor control. As more modern capabilities are employed in surgery and radiotherapy, attention is being directed to the utility of radiation as either primary or secondary treatment of benign tumors. Specifically, primary treatment encompasses irradiation of small benign tumors without biopsy confirmation of tumor type; secondary treatment involves postoperative radiation therapy, with the possibility that less-aggressive tumor resection may be performed in areas that have a higher probability of resultant neurological deficit. Current literature suggests that this is not only a possible treatment strategy, but that it may be superior to more radical resection in some cases, for example, in vestibular schwannomas and meningiomas. This article provides an overview of factors to consider in the use of radiation therapy and reviews the relationships between radiation and surgery, notably the unique complementary role each plays in the treatment of benign intracranial tumors.
从历史上看，放射治疗已广泛用于治疗恶性和侵袭性颅内肿瘤，其作用的重要性已通过患者延长的生存率和提高的肿瘤控制率得到反复验证。随着手术和放射治疗中采用了更多现代技术，人们开始关注放射治疗作为良性肿瘤的主要或次要治疗方法的效用。具体而言，主要治疗包括对小型良性肿瘤进行照射，而无需通过活检确认肿瘤类型；次要治疗则涉及术后放射治疗，在可能导致神经功能缺损概率较高的区域，可能会采用侵袭性较小的肿瘤切除术。当前文献表明，这不仅是一种可行的治疗策略，而且在某些情况下可能优于更激进的切除术，例如在前庭神经鞘瘤和脑膜瘤的治疗中。本文概述了在使用放射治疗时需要考虑的因素，并回顾了放射治疗与手术之间的关系，特别是两者在良性颅内肿瘤治疗中各自发挥的独特互补作用。
