Lo Wei-Lun, Yang Ka-Yen, Huang Yu-Jie, Chen Wu-Fu, Liao Chen-Chieh, Huang Yu-Hua
Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Department of Neurosurgery, Shung-ho Hospital and Taipei Medical University, Teipei, Taiwan.
Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Clin Neurol Neurosurg. 2014 Jun;121:30-4. doi: 10.1016/j.clineuro.2014.03.012. Epub 2014 Mar 18.
The Novalis linear accelerator system, a well developed modality, can be used for stereotactic radiosurgery (SRS). The aim of this study was to clarify the efficiency and safety of Novalis SRS in treating vestibular schwannomas.
This 4-year retrospective study enrolled 23 patients with 26 vestibular schwannomas (3 patients suffered from neurofibromatosis Type II). Five patients had undergone tumor resection. All 26 tumors were treated using Novalis SRS, with a prescription dose that varied between 10 and 16Gy (mean, 11.8±1.7Gy). The average follow-up period was 56.5±22.1 months (range, 17-87 months).
There were 9 men and 14 women. Their mean age at the time of treatment was 54.0±14.6 years (range, 27-84 years). On average, the original size of the tumor was 19.0±7.2mm in maximal diameter (range, 4.6-39.9mm). At the last follow-up, 20 tumors had regressed (76.9%), and there was no observed change in the size of 3 tumors (11.5%). Three of 26 tumors (11.5%) enlarged more than 2mm in one direction. Thus the ultimate radiological tumor control rate was 88.5% (23/26). In addition, 20 (87.0%) patients retained their pre-irradiation hearing function. Facial and trigeminal nerve function were both preserved in all patients. No death occurred during the follow-up, and no patient was treated with a second SRS or converted to tumor resection.
Novalis SRS is a reliable treatment option for vestibular schwannomas. With an optimal radiation dose, satisfactory tumor control can be achieved while preserving cranial nerve function.
诺力刀直线加速器系统是一种成熟的放疗设备，可用于立体定向放射外科治疗（SRS）。本研究旨在阐明诺力刀SRS治疗前庭神经鞘瘤的有效性和安全性。
这项为期4年的回顾性研究纳入了23例患有26个前庭神经鞘瘤的患者（3例患有Ⅱ型神经纤维瘤病）。5例患者曾接受过肿瘤切除术。所有26个肿瘤均采用诺力刀SRS治疗，处方剂量在10至16Gy之间（平均11.8±1.7Gy）。平均随访期为56.5±22.1个月（范围17 - 87个月）。
男性9例，女性14例。治疗时的平均年龄为54.0±14.6岁（范围27 - 84岁）。肿瘤最大直径平均原始大小为19.0±7.2mm（范围4.6 - 39.9mm）。在最后一次随访时，20个肿瘤缩小（76.9%），3个肿瘤大小无变化（11.5%）。26个肿瘤中有3个（11.5%）在一个方向上增大超过2mm。因此最终肿瘤放射学控制率为88.5%（23/26）。此外，20例（87.0%）患者保留了放疗前的听力功能。所有患者的面神经和三叉神经功能均得以保留。随访期间无死亡发生，也没有患者接受第二次SRS治疗或改行肿瘤切除术。
诺力刀SRS是治疗前庭神经鞘瘤的可靠选择。通过优化放射剂量，在保留颅神经功能的同时可实现满意的肿瘤控制。
