Rashid Azhar, Memon Muhammad Ali, Ahmed Usman, Saleem Muhammad Abid, Bhatti Amer Iqtidar, Ahmed Naveed, Hashim Abdul Sattar M
Department of Stereotactic Radiosurgery, Pakistan Gamma Knife & Stereotactic Radiosurgery Center, Neurospinal & Medical Institute Karachi, Pakistan.
Department of Radiology, Jinnah Postgraduate Medical Center Karachi, Pakistan.
J Radiosurg SBRT. 2012;2(1):29-40.
To evaluate the clinical outcome of linear accelerator based multisession stereotactic radiosurgery (SRS) for large benign brain tumors of >3cm.
Between June 2009 and May 2011, 35 patients having large benign brain tumors of >3cm (≥15 cm) were treated by multisession stereotactic radiosurgery. This retrospective study was carried out at Neurospinal & Medical Institute Karachi. There were 17 (48.6 %) males and 18(51.4 %) females. Median age was 36 years (range: 13-65 years). Median target volume was 49.4 cm (range: 15-184 cm). The median marginal dose was 25 Gy (range: 20-27.5Gy) prescribed to a median 75% isodose line (range: 65-100 %). Median number of 5 fractions were used ranging 3-5 fractions.
All the patients tolerated treatment very well. 21 (58.3%) patients had remarkable clinical improvement of neurological symptoms, 14 (38.9%) patients had stable symptoms, and only one patient had transient worsening of symptoms. No permanent neurological damage or radiation injury was seen. Radiologically, 9 (25.7%) patients achieved reduction in size of the tumor, 26(74.3 %) patients were having stable disease, and overall control rate was found to be 100 %. Median follow-up time from the end of SRS was 6.4 months (range: 1-22.5months).
Linear accelerator based multisession stereotactic radiosurgery for large benign brain tumors of >3cm is effective and well tolerated.
评估基于直线加速器的多疗程立体定向放射外科治疗（SRS）对直径大于3cm的大型良性脑肿瘤的临床疗效。
2009年6月至2011年5月期间，35例直径大于3cm（≥15cm）的大型良性脑肿瘤患者接受了多疗程立体定向放射外科治疗。这项回顾性研究在卡拉奇神经脊柱与医学研究所开展。其中男性17例（48.6%），女性18例（51.4%）。中位年龄为36岁（范围：13 - 65岁）。中位靶体积为49.4cm³（范围：15 - 184cm³）。中位边缘剂量为25Gy（范围：20 - 27.5Gy），处方至中位75%等剂量线（范围：65 - 100%）。中位分割次数为5次，范围为3 - 5次。
所有患者对治疗耐受性良好。21例（58.3%）患者神经症状有显著临床改善，14例（38.9%）患者症状稳定，仅有1例患者症状短暂恶化。未观察到永久性神经损伤或放射性损伤。影像学检查显示，9例（25.7%）患者肿瘤体积缩小，26例（74.3%）患者病情稳定，总体控制率为100%。立体定向放射外科治疗结束后的中位随访时间为6.4个月（范围：1 - 22.5个月）。
基于直线加速器的多疗程立体定向放射外科治疗对直径大于3cm的大型良性脑肿瘤有效且耐受性良好。
