立体定向放射手术后的继发肿瘤。
Secondary neoplasms after stereotactic radiosurgery.
机构信息
Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut, USA.
Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut, USA.
出版信息
World Neurosurg. 2014 Mar-Apr;81(3-4):594-9. doi: 10.1016/j.wneu.2013.10.043. Epub 2013 Oct 19.
OBJECTIVE
The use of medical radiation has increased 6-fold in the past 30 years. Within neurosurgery, the advent of stereotactic radiosurgery (SRS) has significantly altered the treatment paradigm for both benign and malignant central nervous system diseases. With this increased reliance on radiation has come a responsibility to identify the long-term risks, including the potential development of radiation-induced neoplasms. Although the data regarding traditional radiation exposure and its subsequent risks are well-defined, the data for SRS is less developed.
METHODS
We reviewed the published literature to more accurately define the risk of developing secondary neoplasms after stereotactic radiosurgery.
RESULTS
A total of 36 cases of SRS-induced neoplasms were identified. More than half of the cases had an initial diagnosis of vestibular schwannoma. Overall, the risk of developing an SRS-induced neoplasm is approximately 0.04% at 15 years.
CONCLUSION
The risk of developing an SRS-induced neoplasm is low but not zero. Thus, long-term surveillance imaging is advised for patients treated with SRS.
目的
在过去的 30 年中，医疗辐射的使用增加了 6 倍。在神经外科领域，立体定向放射外科（SRS）的出现极大地改变了良性和恶性中枢神经系统疾病的治疗模式。随着对辐射的依赖增加，人们有责任识别长期风险，包括潜在的放射性肿瘤的发展。虽然关于传统辐射暴露及其后续风险的数据已经得到很好的定义，但 SRS 的数据还不够完善。
方法
我们回顾了已发表的文献，以更准确地定义立体定向放射外科治疗后发生继发性肿瘤的风险。
结果
共发现 36 例 SRS 诱导的肿瘤。超过一半的病例最初诊断为前庭神经鞘瘤。总的来说，15 年内发生 SRS 诱导性肿瘤的风险约为 0.04%。
结论
SRS 诱导性肿瘤的风险虽然低，但并非为零。因此，建议对接受 SRS 治疗的患者进行长期随访成像。
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