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脊柱和脊髓原发性肿瘤的立体定向放射外科治疗。

Stereotactic radiosurgery for primary tumors of the spine and spinal cord.

作者信息

Elibe Erinma, Boyce-Fappiano David, Ryu Samuel, Siddiqui M Salim, Lee Ian, Rock Jack, Siddiqui Farzan

机构信息

Department of Radiation Oncology, Henry Ford Hospital, 2799 W Grand Blvd Detroit, MI 48202, USA.

Department of Radiation Oncology, Stony Brook University School of Medicine, 101 Nicolls Rd, Stony Brook, NY 11794, USA.

出版信息

J Radiosurg SBRT. 2018;5(2):107-113.

Abstract

PURPOSE

The purpose of this study was to evaluate the role of stereotactic radiosurgery in the treatment of primary tumors of the spine and spinal cord.

METHODS

An Institutional Review Board approved retrospective analysis of 30 patients with primary spine tumors treated at a single institution was performed. Post-treatment pain, neurological, and radiographic responses were the endpoints.

RESULTS

Nine patients were treated for benign tumors, and 21 patients were treated for malignant tumors. The median dose delivered was 16 Gy in one fraction. Median follow up was 13.13 months (range, 1 month-84 months). Pain relief was 88% initially. Pain recurred in five patients with a median time to recurrence of 5 months (range, 3.6 months - 80 months). Neurological improvement was achieved in 65% of patients. Three patients experienced a recurrence in their neurological deficit (at 3.6 months, 1.6 years, and 3.7 years after SRS). Radiographic control was achieved in 77% of sites treated with SRS. Thirteen of the treated sites recurred with a median time of 9.9 months. Two long-term toxicities were observed (asymptomatic radio-necrosis of the erector spinae muscle and foot drop).

CONCLUSIONS

Our results suggest that SRS is a safe and effective treatment option for primary tumors of the spine and spinal cord.

摘要

目的

本研究旨在评估立体定向放射外科在脊柱和脊髓原发性肿瘤治疗中的作用。

方法

对在单一机构接受治疗的30例脊柱原发性肿瘤患者进行了机构审查委员会批准的回顾性分析。治疗后的疼痛、神经功能和影像学反应为观察终点。

结果

9例患者接受良性肿瘤治疗,21例患者接受恶性肿瘤治疗。单次分割给予的中位剂量为16 Gy。中位随访时间为13.13个月(范围1个月 - 84个月)。最初疼痛缓解率为88%。5例患者疼痛复发,复发的中位时间为5个月(范围3.6个月 - 80个月)。65%的患者神经功能得到改善。3例患者神经功能缺损复发(分别在立体定向放射外科治疗后3.6个月、1.6年和3.7年)。接受立体定向放射外科治疗的部位中,77%实现了影像学控制。13个治疗部位复发,中位复发时间为9.9个月。观察到2例长期毒性反应(竖脊肌无症状放射性坏死和足下垂)。

结论

我们的结果表明,立体定向放射外科是脊柱和脊髓原发性肿瘤的一种安全有效的治疗选择。

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本文引用的文献

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Stereotactic radiosurgery for primary malignant spinal tumors.原发性恶性脊柱肿瘤的立体定向放射外科治疗
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Primary spine tumors: diagnosis and treatment.原发性脊柱肿瘤:诊断与治疗。
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Spine radiosurgery: a dosimetric analysis in 124 patients who received 18 Gy.脊柱放射外科手术:124 例接受 18 Gy 剂量的患者的剂量学分析。
Int J Radiat Oncol Biol Phys. 2012 Dec 1;84(5):e571-6. doi: 10.1016/j.ijrobp.2012.06.049. Epub 2012 Sep 11.

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