Matsunaga Shigeo, Shuto Takashi, Suenaga Jun, Inomori Shigeo, Fujino Hideyo
Department of Neurosurgery, Yokohama Rosai Hospital, Yokohama, Kanagawa.
Neurol Med Chir (Tokyo). 2010;50(2):107-12; disucussion 112-3. doi: 10.2176/nmc.50.107.
The long-term outcome of gamma knife radiosurgery (GKS) for central neurocytomas remains unclear. In the present study, we retrospectively reviewed the medical records of 7 patients with 8 central neurocytomas who underwent GKS between March 1997 and April 2007. They were 3 men and 4 women age ranging 9 to 53 years old (mean 32.5 years old). The tumor volume at the time of GKS was 0.34-6.10 cm(3) (mean 3.86 cm(3)). All patients had undergone 1 to 3 incomplete surgical resections (mean 1.75) before GKS, the surgical specimen being evaluated histologically and immunohistochemically. The follow-up period after GKS was 15 to 136 months (mean 63.6 months). The tumors were treated with a marginal dose of 12-18 Gy (mean 13.9 Gy). Only one of the seven patients died of tumor recurrence and intracranial hemorrhage 40 months after GKS. The other tumors remained progression-free. The control rate of the tumor growth was 7/8. Although histological malignant transformation is rare, the postoperative course of this tumor is not always good, showing tumor progression, intracranial hemorrhage, or craniospinal dissemination. Therefore, we recommend GKS for residual or recurrent tumors especially at early detection before tumor progression.
伽玛刀放射外科治疗（GKS）中枢神经细胞瘤的长期疗效仍不明确。在本研究中，我们回顾性分析了1997年3月至2007年4月期间接受GKS治疗的7例患者8个中枢神经细胞瘤的病历资料。患者年龄9至53岁（平均32.5岁），男性3例，女性4例。GKS治疗时肿瘤体积为0.34 - 6.10 cm³（平均3.86 cm³）。所有患者在GKS治疗前均接受过1至3次不完全手术切除（平均1.75次），手术标本进行了组织学和免疫组织化学评估。GKS治疗后的随访期为15至136个月（平均63.6个月）。肿瘤边缘剂量为12 - 18 Gy（平均13.9 Gy）。7例患者中仅1例在GKS治疗后40个月死于肿瘤复发和颅内出血。其他肿瘤无进展。肿瘤生长控制率为7/8。虽然组织学恶性转化罕见，但该肿瘤的术后病程并非总是良好，可出现肿瘤进展、颅内出血或颅脊髓播散。因此，我们推荐GKS用于治疗残留或复发肿瘤，尤其是在肿瘤进展前的早期发现阶段。
