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伽玛刀放射外科治疗中枢神经细胞瘤:单机构 25 例经验。

Gamma Knife radiosurgery for the treatment of central neurocytoma: a single-institution experience of 25 patients.

机构信息

School of Medicine, Department of Neurosurgery, Koç University, İstanbul, Turkey.

Department of Neurosurgery, Koç University Hospital, Istanbul, Turkey.

出版信息

Neurosurg Rev. 2021 Dec;44(6):3427-3435. doi: 10.1007/s10143-021-01518-0. Epub 2021 Mar 17.

Abstract

Central neurocytomas (CNs) are extremely rare tumors that account for 0.1-0.5% of all intracranial neoplasms. Recently, Gamma Knife radiosurgery (GKRS) has become a treatment option in patients with CN. We aimed to evaluate the efficacy and safety of GKRS in 25 CN patients and review the results along with relevant literature. GKRS patient database was searched, and 25 patients who underwent GKRS for CN between 2009 and 2018, were evaluated retrospectively. The study cohort included 15 female and ten male patients with a median age of 32 years (range, 5-60). The most common presenting symptom was headache (88%). The neurological examination was unremarkable in all patients, except for one patient with decreased vision. Twenty patients (80%) had a history of surgical resection. Most of the tumors (92%) were located in the ventricles, and the median tumor volume was 4.8 cm (range, 0.8-28.1). The median marginal dose was 14 Gy (range, 12-15) to a median isodose of 50% (range, 40-50). Following a median follow-up of 80 months (range, 36-138), local tumor control was achieved in 100% of patients. Distant recurrence was observed in one patient (4%). No adverse radiation effect was observed. Regarding non-specific post-GKRS symptoms, one patient experienced a prolonged headache, and one epileptic patient experienced a brief partial seizure. In our patient cohort, GKRS yielded favorable local tumor control (100%) during a median follow-up of 6.6 years. Our series demonstrates that GKRS is an effective and safe treatment option for patients with primary or residual CNs.

摘要

中枢神经细胞瘤(CNs)是极为罕见的肿瘤,占所有颅内肿瘤的 0.1-0.5%。最近,伽玛刀放射外科(GKRS)已成为 CN 患者的一种治疗选择。我们旨在评估 25 例 CN 患者接受 GKRS 治疗的疗效和安全性,并结合相关文献回顾结果。检索 GKRS 患者数据库,回顾性分析 2009 年至 2018 年间接受 GKRS 治疗的 25 例 CN 患者。研究队列包括 15 例女性和 10 例男性患者,中位年龄为 32 岁(范围 5-60 岁)。最常见的首发症状是头痛(88%)。除 1 例视力下降的患者外,所有患者的神经系统检查均无异常。20 例(80%)有手术切除史。大多数肿瘤(92%)位于脑室,肿瘤体积中位数为 4.8cm(范围 0.8-28.1)。边缘剂量中位数为 14Gy(范围 12-15),等剂量 50%(范围 40-50)。中位随访 80 个月(范围 36-138)后,100%的患者实现了局部肿瘤控制。1 例(4%)患者出现远处复发。未观察到放射性不良反应。关于非特异性 GKRS 后症状,1 例患者出现持续性头痛,1 例癫痫患者出现短暂部分性癫痫发作。在我们的患者队列中,GKRS 在中位 6.6 年的随访期间实现了良好的局部肿瘤控制(100%)。我们的研究表明,GKRS 是治疗原发性或残留 CN 的有效且安全的治疗选择。

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