Kazda T, Pospisil P, Vrzal M, Sevela O, Prochazka T, Jancalek R, Slampa P, Laack N N
Department of radiation oncology, faculty of medicine, Masaryk university, Masaryk memorial cancer institute, Zlutykopec 7, 656 53 Brno, Czech Republic; International clinical research center, St. Anne's university hospital Brno, Pekarska 53, 656 91 Brno, Czech Republic.
Department of radiation oncology, faculty of medicine, Masaryk university, Masaryk memorial cancer institute, Zlutykopec 7, 656 53 Brno, Czech Republic.
Cancer Radiother. 2015 May;19(3):187-91. doi: 10.1016/j.canrad.2014.11.013. Epub 2015 Mar 30.
Timing of radiotherapy for low-grade gliomas is still controversial due to concerns of possible adverse late effects. Prevention of possible late cognitive sequelae by hippocampal avoidance has shown promise in phase II trials. A patient with progressive low-grade glioma with gradual dedifferentiation into anaplastic astrocytoma is presented along with description of radiotherapy planning process attempting to spare the hippocampus. To our knowledge, this is the first described case using volumetric modulated arc technique to spare hippocampus during transformed low-grade glioma radiotherapy. Using modern intensity-modulated radiotherapy systems it is possible to selectively spare hippocampus together with other standard organs at risk. For selected patients, an attempt to spare hippocampus can be considered as long as other dose characteristics are not significantly compromised compared to standard treatment plan created without any effort to avoid hippocampus.
由于担心可能出现的晚期不良影响，低级别胶质瘤放疗的时机仍存在争议。在II期试验中，通过避开海马体预防可能出现的晚期认知后遗症已显示出前景。本文介绍了一名低级别胶质瘤进展并逐渐去分化为间变性星形细胞瘤的患者，同时描述了试图保护海马体的放疗计划制定过程。据我们所知，这是首例在低级别胶质瘤转化放疗期间使用容积调强弧形技术保护海马体的病例。使用现代调强放疗系统，可以选择性地保护海马体以及其他标准危及器官。对于选定的患者，只要与未采取任何措施避开海马体而制定的标准治疗计划相比，其他剂量特征没有受到显著影响，就可以考虑尝试保护海马体。
