Kazemi Farid, Azar Mazyar, Kazemi Foad, Hadisinia Tahereh, Teymori Javad, Geraily Ghazale
Skull Base Research Center, Neurosurgery Department, Iran University of Medical Science, Tehran, Iran.
Iran Gamma Knife Center, Tehran, Iran.
Rep Pract Oncol Radiother. 2021 Dec 30;26(6):915-919. doi: 10.5603/RPOR.a2021.0108. eCollection 2021.
Stereotactic radiosurgery (SRS) method has been considered the first-line treatment option to treat patients involved with pre-optic nerve tumors. However, studies have shown that using fractionated SRS, normal tissue sparing and tumor dose can be strongly increased simultaneously. Our main goal was to illustrate the effects of fractionated SRS approach in optic nerve tumor treatment and its adjacent sensitive structures.
19 patients involved in optic nerve tumor with clinical symptoms of vision loss were treated with Gamma Knife radiosurgery in three sessions with 12 hours intervals between them. The prescribed dose was about 6.0 ± 1.2 Gy. Patient-related parameters including pre-treatment and after-treatment tumor size, visual acuity and visual field were evaluated using the Snell chart and MRI imaging. Patients were followed for about 14 months.
The overall result showed vision improvement for patients with low and moderate visual loss. However, there was no significant improvement in patients with severe visual loss. Relative improvement was observed in blind patients, although poorly. There was no evidence of growth, recurrence, or new tumor after treatment in patients.
Fractionated gamma knife radiosurgery offers a safe and effective alternative for benign lesions adjacent to the optic nerve.
立体定向放射外科（SRS）方法一直被认为是治疗视交叉前区神经肿瘤患者的一线治疗选择。然而，研究表明，使用分次立体定向放射外科，正常组织保护和肿瘤剂量可同时显著增加。我们的主要目标是阐述分次立体定向放射外科方法在视神经肿瘤治疗及其相邻敏感结构中的效果。
19例有视力丧失临床症状的视神经肿瘤患者接受了伽玛刀放射外科治疗，分三次进行，每次间隔12小时。规定剂量约为6.0±1.2 Gy。使用斯内伦视力表和MRI成像评估与患者相关的参数，包括治疗前和治疗后肿瘤大小、视力和视野。对患者进行了约14个月的随访。
总体结果显示，轻度和中度视力丧失患者的视力有所改善。然而，严重视力丧失患者没有明显改善。失明患者有相对改善，尽管改善程度不佳。治疗后患者没有出现肿瘤生长、复发或新肿瘤的证据。
分次伽玛刀放射外科为视神经附近的良性病变提供了一种安全有效的替代治疗方法。
