Litré Claude Fabien, Colin Philippe, Noudel Remy, Peruzzi Philippe, Bazin Arnaud, Sherpereel Bernard, Bernard Marie Helene, Rousseaux Pascal
Department of Neurosurgery, Maison Blanche Hospital, Reims, France.
Int J Radiat Oncol Biol Phys. 2009 Jul 15;74(4):1012-7. doi: 10.1016/j.ijrobp.2008.09.012. Epub 2008 Dec 30.
We discuss our experiences with fractionated stereotactic radiotherapy (FSR) in the treatment of cavernous sinus meningiomas.
From 1995 to 2006, we monitored 100 patients diagnosed with cavernous sinus meningiomas; 84 female and 16 male patients were included. The mean patient age was 56 years. The most common symptoms were a reduction in visual acuity (57%), diplopia (50%), exophthalmy (30%), and trigeminal neuralgia (34%). Surgery was initially performed on 26 patients. All patients were treated with FSR. A total of 45 Gy was administered to the lesion, with 5 fractions of 1.8 Gy completed each week. Patient treatment was performed using a Varian Clinac linear accelerator used for cranial treatments and a micro-multileaf collimator.
No side effects were reported. Mean follow-up period was 33 months, with 20% of patients undergoing follow-up evaluation of more than 4 years later. The tumor control rate at 3 years was 94%. Three patients required microsurgical intervention because FSR proved ineffective. In terms of functional symptoms, an 81% improvement was observed in patients suffering from exophthalmy, with 46% of these patients being restored to full health. A 52% improvement was observed in diplopia, together with a 67% improvement in visual acuity and a 50% improvement in type V neuropathy.
FSR facilitates tumor control, either as an initial treatment option or in combination with microsurgery. In addition to being a safe procedure with few side effects, FSR offers the significant benefit of superior functional outcomes.
我们探讨了分次立体定向放射治疗（FSR）在海绵窦脑膜瘤治疗中的经验。
1995年至2006年，我们对100例诊断为海绵窦脑膜瘤的患者进行了监测，其中包括84例女性和16例男性患者。患者的平均年龄为56岁。最常见的症状是视力下降（57%）、复视（50%）、眼球突出（30%）和三叉神经痛（34%）。最初对26例患者进行了手术。所有患者均接受了FSR治疗。对病变共给予45 Gy的剂量，每周完成5次，每次1.8 Gy。使用用于颅脑治疗的Varian Clinac直线加速器和微型多叶准直器对患者进行治疗。
未报告有副作用。平均随访期为33个月，20%的患者在4年多后接受了随访评估。3年时的肿瘤控制率为94%。3例患者因FSR无效而需要进行显微手术干预。在功能症状方面，眼球突出患者中有81%的症状得到改善，其中46%的患者恢复到完全健康状态。复视改善了52%，视力改善了67%，V型神经病变改善了50%。
FSR无论是作为初始治疗选择还是与显微手术联合使用，都有助于控制肿瘤。除了是一种副作用少的安全治疗方法外，FSR还具有功能预后良好的显著优势。
