Gamma Knife Center, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, PR China.
Gamma Knife Center, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, PR China.
Clin Neurol Neurosurg. 2020 Oct;197:106169. doi: 10.1016/j.clineuro.2020.106169. Epub 2020 Aug 22.
The treatment safety and efficiency as well as the life quality of patients are still main concerns in gamma knife radiosurgery. In this study, the feasibility of applying diffusion tensor imaging (DTI) in gamma knife radiosurgery for the treatment of brain tumor in motor function areas was investigated, which aims to provide protection on the pyramidal tract and preserve the motor function in patients.
Total 74 patients with solid brain tumor were enrolled and divided into DTI group and control group. The tumor control rate was assessed at 3 months after surgery. The muscle strength of affected limb, KPS scores, ZEW scores and complications were evaluated at 3 and 6 months after gamma knife radiosurgery.
Our results indicated that the tumor control rate, complication rate, the muscle strength of affected limb and KPS scores were not significantly different between the two groups at 3 months after surgery. At 6 months after gamma knife radiosurgery, the complication rate (0% vs 50 %, P = 0.044), KPS scores (64.9 % vs 37.8 %, P = 0.036) and ZEW scores (78.4 % vs 54.1 %, P = 0.044) of DTI group were better than the control group. Furthermore, the stability of muscle strength in patients with limb dysfunction was significantly improved in DTI group (86.4 % vs 50 %, P = 0.028).
In summary, the application of DTI in gamma knife radiosurgery for the treatment of brain tumors in motor function areas can precisely define the tumor edge from pyramidal tract, which will support on designing individual treatment plan, reducing the incidence of complications, and improving long-term life quality in patients.
在伽玛刀放射外科中，患者的治疗安全性和效率以及生活质量仍然是主要关注点。在这项研究中，探讨了扩散张量成像（DTI）在伽玛刀放射外科治疗运动功能区脑肿瘤中的应用可行性，旨在为保护锥体束和保留患者运动功能提供帮助。
共纳入 74 例实体脑肿瘤患者，分为 DTI 组和对照组。术后 3 个月评估肿瘤控制率。术后 3 个月和 6 个月评估患侧肢体肌力、KPS 评分、ZEW 评分和并发症。
结果表明，术后 3 个月两组肿瘤控制率、并发症发生率、患侧肢体肌力和 KPS 评分无显著差异。伽玛刀放射外科治疗后 6 个月，DTI 组并发症发生率（0%比 50%，P=0.044）、KPS 评分（64.9%比 37.8%，P=0.036）和 ZEW 评分（78.4%比 54.1%，P=0.044）优于对照组。此外，DTI 组肢体功能障碍患者的肌力稳定性明显改善（86.4%比 50%，P=0.028）。
总之，DTI 在运动功能区脑肿瘤伽玛刀放射外科治疗中的应用可以从锥体束精确界定肿瘤边缘，有助于制定个体化治疗计划，降低并发症发生率，提高患者的长期生活质量。
