Mori Yoshimasa, Hashizume Chisa, Shibamoto Yuta, Kobayashi Tatsuya, Nakazawa Hisato, Hagiwara Masahiro, Tsugawa Takahiko
Nagoya J Med Sci. 2013 Aug;75(3-4):263-71.
Results of stereotactic radiotherapy (SRT) for spinal intradural metastases developing inside or adjacent to the previous external-beam radiation therapy (EBRT) field are shown in 3 cases. One case of spinal intramedullary metastasis and two cases of intradural extramedullary metastases were treated using a Novalis shaped-beam SRT. Case 1 developed an intramedullary metastatic tumor in the C1 spinal medulla inside the previous whole brain EBRT field and another lesion adjacent to the field in the C2 spinal medulla. Case 2 developed intradural extramedullary metastasis around C6-8 inside the previous EBRT field for the primary lung adenocarcinoma. Case 3 developed multiple spinal intradural extramedullary metastatic deposits after surgical resection and following whole brain EBRT for brain metastasis. We delivered 24 to 36 Gy in 5 to 12 fractions. The treated tumors were stable or decreased in size until the patients' death from the primary cancer (10, 22, and 5 months). Neurological symptoms were stable or improved in all 3 patients. Palliative SRT using Novalis is expected to be safe and effective even if the patient develops spinal intradural metastases within or adjacent to the previous irradiation field.
3例患者显示了立体定向放射治疗（SRT）对先前外照射放疗（EBRT）野内或其附近发生的脊髓硬膜内转移瘤的治疗结果。1例脊髓髓内转移瘤和2例硬膜内髓外转移瘤采用Novalis塑形束SRT治疗。病例1在先前全脑EBRT野内的C1脊髓髓质出现髓内转移瘤，并在C2脊髓髓质出现1个与该野相邻的病灶。病例2在先前针对原发性肺腺癌的EBRT野内的C6 - 8周围出现硬膜内髓外转移瘤。病例3在手术切除及全脑EBRT治疗脑转移瘤后出现多个脊髓硬膜内髓外转移灶。我们分5至12次给予24至36 Gy剂量。直至患者因原发性癌症死亡（分别为10、22和5个月），所治疗的肿瘤大小稳定或缩小。所有3例患者的神经症状均稳定或改善。即使患者在先前照射野内或其附近发生脊髓硬膜内转移瘤，使用Novalis进行姑息性SRT预计也是安全有效的。
