Mishra Harshit, Pahwa Bhavya, Agrawal Deepak, M Ch Manmohan Singh, M Ch S S Kale
Consultant Neurosurgeon, We Care Hospital, Raipur, Chhattisgarh, India.
University College of Medical Sciences and GTB Hospital, Delhi, India.
Childs Nerv Syst. 2022 May;38(5):909-918. doi: 10.1007/s00381-022-05463-1. Epub 2022 Mar 15.
Brain tumours have an incidence of 1.15 to 5.14 cases per 100,000 children and are associated with significant morbidity and mortality. Radiosurgery has become a promising approach to manage these paediatric CNS tumours. The aim of the present study was to analyse the efficacy of radiosurgery in the treatment of a variety of paediatric tumours of CNS.
This retrospective study was conducted from 1997 to 2012 at a single Neurosurgery centre. All paediatric patients (≤ 18 years of age) with CNS tumours who were treated with gamma knife radiosurgery (GKRS) and had a minimum follow up of 6 months were included in the study. Patients with lesions other than tumours were excluded. Clinical, radiological and GKRS planning data was collected and analysed in all patients.
A total of 76 children with brain tumours had GKRS during the study period. Of these, 40 children (with 61 neoplasms) had follow-up available and were included in the study. The mean age was 16 years (6-18 years). Seventeen patients received primary GKRS, 20 patients received secondary, and 3 patients received both. The median tumour volume was 3.3 cm (0.14-38.9 cm3). The mean dose was 12.56 Gy at 50% isodose line. The majority of the tumours were meningioma (n = 20) followed by acoustic schwannoma (n = 17). The mean treatment time was 67.04 min. Thirty-three tumours responded favourably to GKRS, 24 showed a stable size, 3 had no response while 1 progressed, requiring surgery.
GKRS has the potential to become an indispensable tool in the management of paediatric brain neoplasms.
脑肿瘤在每10万名儿童中的发病率为1.15至5.14例，且与显著的发病率和死亡率相关。放射外科已成为治疗这些小儿中枢神经系统肿瘤的一种有前景的方法。本研究的目的是分析放射外科治疗各种小儿中枢神经系统肿瘤的疗效。
本回顾性研究于1997年至2012年在一个单一的神经外科中心进行。所有接受伽玛刀放射外科（GKRS）治疗且至少随访6个月的小儿中枢神经系统肿瘤患者（≤18岁）纳入研究。排除肿瘤以外病变的患者。收集并分析所有患者的临床、放射学和GKRS计划数据。
在研究期间，共有76例脑肿瘤患儿接受了GKRS。其中，40例患儿（61个肿瘤）有随访资料并纳入研究。平均年龄为16岁（6至18岁）。17例患者接受了初次GKRS，20例接受了二次GKRS，3例两者均接受。肿瘤体积中位数为3.3 cm（0.14至38.9 cm³）。50%等剂量线处的平均剂量为12.56 Gy。大多数肿瘤为脑膜瘤（n = 20），其次是听神经鞘瘤（n = 17）。平均治疗时间为67.04分钟。33个肿瘤对GKRS反应良好，24个肿瘤大小稳定，3个无反应，1个进展，需行手术治疗。
GKRS有潜力成为小儿脑肿瘤治疗中不可或缺的工具。
