Pence D M, Kim T H, Levitt S H
Department of Therapeutic Radiology, Radiation Oncology, University of Minnesota Hospital and Clinic, Minneapolis 55455.
Int J Radiat Oncol Biol Phys. 1990 May;18(5):1001-4. doi: 10.1016/0360-3016(90)90433-k.
This report is a 20-year follow-up of 14 patients treated with external beam craniospinal irradiation and intrathecal gold (10-45 mCi) for medulloblastoma. Six of the patients died within 2 years of treatment from persistent disease. No patients are alive without complications. Six of eight surviving patients developed arachnoiditis and cauda equina syndrome within 5 to 10 years of treatment. Seven of eight survivors developed aneurysms and/or cerebrovascular accidents 9 to 20 years after treatment. Four of the cerebrovascular events were fatal. Intrathecal gold pools in the basal cisterns and cauda equina delivering an extremely inhomogeneous dose throughout the neuroaxis. Its use is discouraged.
本报告是对14例接受髓母细胞瘤全脑全脊髓外照射和鞘内注射金（10 - 45毫居里）治疗患者的20年随访。6例患者在治疗后2年内因疾病持续存在而死亡。没有患者无并发症存活。8名存活患者中有6例在治疗后5至10年内出现蛛网膜炎和马尾综合征。8名幸存者中有7例在治疗后9至20年出现动脉瘤和/或脑血管意外。其中4例脑血管事件是致命的。鞘内注射的金在脑基底池和马尾聚集，在整个神经轴上产生极不均匀的剂量。不建议使用。
