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前庭神经鞘瘤:一种不寻常的放疗后反应。

Vestibular schwannoma: an unusual post radiotherapy response.

作者信息

Uddin Najam, Iqbal Muhammad, Memon Muhammad Ali, Farrukh Salman

机构信息

Department of Radiation Oncology, Atomic Energy Medical Centre (AEMC), JPMC, Karachi.

出版信息

J Coll Physicians Surg Pak. 2014 Nov;24 Suppl 3:S278-80.

Abstract

Vestibular schwannoma is a relatively uncommon tumor. Although, it is benign but locally expansile and spreads to damage the adjacent structures. Treatment strategy includes surgery, Stereotactic Radiosurgery (SRS) either by standard or hypofractionated protocols. Due to its benign nature, radiation therapy cannot remove the tumor completely, instead radiation therapy halts the growth of vestibular schwannoma and inactivates this benign tumor. Response of radiation in the form of tumor shrinkage is seen 2 - 2.5 years after the radiations. We report a case of vestibular Schwannoma in which residual tumor of 3.1 cm size following subtotal resection was irradiated of the dose of 54 Gy in 30 equal fractions on 3-Dimensional Conformal Radiation Therapy (3-DCRT). A follow-up CT scan brain after 2 months of radiotherapy showed complete disappearance of the disease categorized as complete response. This is an unusual phenomenon and is likely due to the very rarely seen malignant transformation or presence of malignant component in this benign tumor.

摘要

前庭神经鞘瘤是一种相对罕见的肿瘤。虽然它是良性的,但具有局部扩张性,并会扩散以损害相邻结构。治疗策略包括手术、采用标准或大分割方案的立体定向放射外科治疗(SRS)。由于其良性性质,放射治疗无法完全切除肿瘤,相反,放射治疗会阻止前庭神经鞘瘤的生长并使这种良性肿瘤失活。在放疗后2至2.5年可观察到肿瘤缩小形式的放射反应。我们报告一例前庭神经鞘瘤病例,在次全切除后残留3.1厘米大小的肿瘤,采用三维适形放射治疗(3-DCRT)给予54 Gy的剂量,分30等份照射。放疗2个月后的脑部随访CT扫描显示疾病完全消失,归类为完全缓解。这是一种不寻常的现象,可能是由于这种良性肿瘤中非常罕见的恶性转化或恶性成分的存在。

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