McGahan R A, Durrance F Y, Parke R B, Easley J D, Chou J L
Radiation Oncology, Methodist Hospital, Baylor College of Medicine, Houston, Texas.
Int J Radiat Oncol Biol Phys. 1989 Nov;17(5):1067-72. doi: 10.1016/0360-3016(89)90157-0.
Fifteen patients with juvenile nasopharyngeal angiofibroma (JNA) were treated in the Department of Radiation Oncology, Baylor College of Medicine between 1973 and 1986. All patients underwent radiographic evaluation including CT scanning, selective digital subtraction angiography, tomograms, or MRI. Patients referred for definitive irradiation exhibited extensive tumor involvement. Eleven of 15 patients had middle cranial fossa involvement; cavernous sinus extension was observed in six patients. Ten patients were treated with primary radiation therapy; five patients had surgical resection initially and were referred for radiation therapy upon local recurrence. Follow-up ranges from 1 1/2-13 years. Four of the 5 patients who received 3200 cGy in 200 cGy fractions demonstrated tumor recurrence within 2 years after irradiation. All recurrences were ultimately controlled by either further irradiation and/or resection. No tumor recurrence was encountered among the patients treated at the higher tumor doses (36-46 Gy). No severe complications have been observed. Radiation therapy utilizing carefully tailored fields is an appropriate therapeutic approach to patients with extensive disease or intracranial extension. A total dose of greater than 40 Gy may allow improved local control for advanced lesions.
1973年至1986年间，贝勒医学院放射肿瘤学系对15例青少年鼻咽血管纤维瘤（JNA）患者进行了治疗。所有患者均接受了影像学评估，包括CT扫描、选择性数字减影血管造影、体层摄影或MRI。因明确放疗前来就诊的患者显示出广泛的肿瘤累及。15例患者中有11例累及中颅窝；6例观察到海绵窦受累。10例患者接受了原发性放射治疗；5例患者最初接受了手术切除，局部复发后转诊接受放射治疗。随访时间为1.5至13年。5例接受200 cGy分次照射、总剂量为3200 cGy的患者中有4例在放疗后2年内出现肿瘤复发。所有复发病例最终均通过进一步放疗和/或切除得到控制。在接受更高肿瘤剂量（36 - 46 Gy）治疗的患者中未出现肿瘤复发。未观察到严重并发症。对于患有广泛疾病或颅内扩展的患者，采用精心定制照射野的放射治疗是一种合适的治疗方法。对于晚期病变，总剂量大于40 Gy可能会改善局部控制。
