Lozada David, Brau Ricardo H
Section of Neurological Surgery, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.
P R Health Sci J. 2010 Sep;29(3):286-92.
Historically, the treatment for most intracranial pathologies has included medical management, surgery, radiotherapy and recently, stereotactic radiosurgery. Since its introduction, stereotactic radiosurgery has evolved from an investigational concept into a recognized neurosurgical procedure for the management of a wide variety of brain disorders. The goal of this research was to describe the experience in Puerto Rico using this technology and review the efficacy, safety, and role of radiosurgery in the treatment of the most common intracranial tumors treated today. Patients treated from 1999-2009 at Clinicas Las Americas were reviewed and medical literature databases were searched for articles pertaining to stereotactic radiosurgery performed in these intracranial tumor pathologies: meningiomas, gliomas, cerebral metastasis, vestibular schwannomas and pituitary adenomas. Each study was examined to determine the radiosurgical parameters, duration of follow-up review, tumor growth control rate and complications. A total of 50 peer-reviewed studies were examined. Radiosurgery in benign tumors resulted in the control of tumor size in 90% of treated patients. Unfortunately radiosurgery for malignant tumors is not curative, but has been effective in improving survival and quality of life. Although microsurgery remains the primary treatment modality in most cases, stereotactic radiosurgery offers both safe and effective treatment for much intracranial pathologies. Further refinements in the radiosurgical technique will likely lead to improved outcomes and make it a standard of care.
从历史上看，大多数颅内疾病的治疗方法包括药物治疗、手术、放射治疗，最近还包括立体定向放射外科治疗。自引入以来，立体定向放射外科已从一个研究概念发展成为一种公认的神经外科手术，用于治疗多种脑部疾病。本研究的目的是描述波多黎各使用该技术的经验，并回顾放射外科在治疗当今最常见颅内肿瘤中的疗效、安全性和作用。对1999年至2009年在美洲诊所接受治疗的患者进行了回顾，并在医学文献数据库中搜索了与这些颅内肿瘤疾病（脑膜瘤、胶质瘤、脑转移瘤、前庭神经鞘瘤和垂体腺瘤）中进行的立体定向放射外科有关的文章。对每项研究进行检查，以确定放射外科参数、随访时间、肿瘤生长控制率和并发症。共检查了50项经同行评审的研究。良性肿瘤的放射外科治疗使90%的治疗患者的肿瘤大小得到控制。不幸的是，恶性肿瘤的放射外科治疗不能治愈，但在提高生存率和生活质量方面已取得成效。尽管在大多数情况下显微手术仍然是主要的治疗方式，但立体定向放射外科为许多颅内疾病提供了安全有效的治疗方法。放射外科技术的进一步改进可能会带来更好的治疗效果，并使其成为一种标准的治疗方法。
