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视神经鞘膜瘤:放射治疗作用的初步分析

Optic Nerve Sheath Meningioma: Preliminary Analysis of the Role of Radiation Therapy.

作者信息

Jin Jun, Joo Jin Deok, Han Jung Ho, Yang Hee Kyung, Hwang Jeong Min, Kim Yi Jun, Kim In Ah, Kim Chae Yong

机构信息

Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea.

Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea.

出版信息

Brain Tumor Res Treat. 2018 Apr;6(1):8-12. doi: 10.14791/btrt.2018.6.e2. Epub 2018 Apr 2.

Abstract

BACKGROUND

The purpose of this study was to evaluate the treatment outcome of our optic nerve sheath meningioma (ONSM) case series in terms of preventing tumor growth and preserving vision in ONSM patients.

METHODS

Between July 2003 and March 2015, 1,398 patients with intracranial meningioma were diagnosed at Seoul National University Bundang Hospital. Among them, only 13 patients (0.93%) were diagnosed with ONSM and enrolled in the present study. Tumor volume changes of ONSM patients and their visual acuity were evaluated before and after treatments.

RESULTS

The median follow-up time was 50 months (range, 12-133 months). Visual acuity was evaluated in 12 of 13 patients, and visual acuity was found to be preserved in 9 of 12 patients (75%). Tumor volume was reduced in all patients. The tumor control rate was 100% in the present study. The difference in tumor volume between pretreatment and last follow-up was statistically significant (p=0.015).

CONCLUSION

Intensity-modulated radiotherapy (IMRT) and gamma knife radiosurgery (GKS) could maintain visual acuity and stabilize tumor volume in ONSM patients, suggesting that IMRT and GKS may be effective therapies for ONSM. However, which treatment is the more effective modality must be confirmed by prospective studies and longer-term follow-up.

摘要

背景

本研究的目的是评估我们视神经鞘膜瘤(ONSM)病例系列在预防肿瘤生长和保留ONSM患者视力方面的治疗效果。

方法

2003年7月至2015年3月期间,首尔国立大学盆唐医院诊断出1398例颅内脑膜瘤患者。其中,只有13例患者(0.93%)被诊断为ONSM并纳入本研究。评估了ONSM患者治疗前后的肿瘤体积变化及其视力。

结果

中位随访时间为50个月(范围12 - 133个月)。13例患者中的12例进行了视力评估,12例患者中有9例(75%)视力得以保留。所有患者的肿瘤体积均减小。本研究中的肿瘤控制率为100%。治疗前与最后一次随访之间的肿瘤体积差异具有统计学意义(p = 0.015)。

结论

调强放射治疗(IMRT)和伽玛刀放射外科治疗(GKS)可维持ONSM患者的视力并稳定肿瘤体积,这表明IMRT和GKS可能是治疗ONSM的有效方法。然而,哪种治疗方式更有效必须通过前瞻性研究和长期随访来确定。

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J Clin Neurosci. 2013 Aug;20(8):1045-56. doi: 10.1016/j.jocn.2013.03.008. Epub 2013 Jun 25.
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Radiotherapy for optic nerve sheath meningioma: a case for earlier intervention?视神经鞘脑膜瘤的放射治疗:是否需要更早干预?
Clin Oncol (R Coll Radiol). 2013 Jun;25(6):356-61. doi: 10.1016/j.clon.2013.02.004. Epub 2013 Mar 13.
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Fractionated stereotactic conformal radiotherapy for optic nerve sheath meningiomas.分次立体定向适形放疗视神经鞘脑膜瘤。
Clin Oncol (R Coll Radiol). 2012 Oct;24(8):e106-12. doi: 10.1016/j.clon.2012.03.015. Epub 2012 May 22.
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Fractionated stereotactic radiotherapy in patients with optic nerve sheath meningioma.分次立体定向放射治疗视神经鞘脑膜瘤。
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