Kim Jong-Won, Im Yong-Seok, Nam Do-Hyun, Park Kwan, Kim Jong-Hyun, Lee Jung-Il
Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
J Korean Neurosurg Soc. 2008 Aug;44(2):67-71. doi: 10.3340/jkns.2008.44.2.67. Epub 2008 Aug 30.
Radiosurgery may be contraindicated for lesions adjacent to the optic pathways because of the substantial risk of visual complication. Multisession radiosurgery has been tried as a compromise between single session radiosurgery and fractionated radiotherapy. The purpose of this study is to evaluate the outcomes of multisession gamma knife radiosurgery (GKRS) in 22 patients with perioptic lesions of benign pathology.
In all 22 cases, the lesions were within 1 mm of the optic apparatus and were therefore not considered suitable for single session radiosurgery. Radiation was delivered in 3 to 4 fractions with a median cumulated marginal dose of 20 Gy (range, 15-20 Gy).
During a mean follow-up of 29 months (range, 14-44 months), tumor control was achieved in 21 patients. Visual function improved in 7 patients, remained unchanged in 14 patients, and deteriorated in 1 patient with tumor progression. No other complication was observed.
This preliminary result supports the idea that multisession GKRS may be an effective and safe alternative for treatment in perioptic lesions that are unsuitable for single session radiosurgery.
由于存在显著的视觉并发症风险，放射外科手术可能不适用于紧邻视路的病变。多疗程放射外科手术已被尝试作为单疗程放射外科手术和分次放射治疗之间的折衷方案。本研究的目的是评估22例患有良性病理的视周病变患者接受多疗程伽玛刀放射外科手术（GKRS）的结果。
在所有22例病例中，病变距离视器不到1毫米，因此被认为不适合单疗程放射外科手术。分3至4次进行放射治疗，累积边缘剂量中位数为20 Gy（范围15 - 20 Gy）。
在平均29个月（范围14 - 44个月）的随访期间，21例患者实现了肿瘤控制。7例患者视觉功能改善，14例患者视觉功能保持不变，1例肿瘤进展患者视觉功能恶化。未观察到其他并发症。
这一初步结果支持这样的观点，即多疗程GKRS对于不适合单疗程放射外科手术的视周病变可能是一种有效且安全的治疗选择。
