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分次剂量伽玛刀放射外科治疗脑膜瘤：单中心回顾性研究

Dose-staged Gamma Knife radiosurgery for meningiomas: A retrospective study in a single center.

作者信息

Gong Xiu, Ding Jianbo, Knisely Jonathan P S, Wang Enmin, Pan Li, Wang Binjiang, Zhang Nan, Wu Hanfeng, Dai Jiazhong, Yu Tonggang, Tang Xuqun

机构信息

Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.

Department of Neurosurgery, Shanghai Gamma Hospital, Shanghai, China.

出版信息

Front Neurol. 2022 Oct 13;13:893480. doi: 10.3389/fneur.2022.893480. eCollection 2022.

DOI:10.3389/fneur.2022.893480
PMID:36313491
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9606413/
Abstract

OBJECTIVE

This study aimed to study the efficiency and safety of a dose-staged Gamma Knife radiosurgery strategy for large meningiomas or meningiomas close to important nerve structures.

METHODS

This study evaluates the outcome of a prospectively accrued series of 71 consecutive patients with meningiomas treated with staged dose-fractionated Gamma Knife radiosurgery. The average peripheral doses for the first and second fractions were 9.0 ± 0.9 Gy (8-12 Gy) and 8.6 ± 0.7 Gy (range, 7-10 Gy), respectively. The interval between fractions was 6.1 ± 1.9 months (range, 3-12 months). The median follow-up time was 36 months (12-96 months).

RESULTS

During the follow-up period after the second fraction, 97.2% achieved tumor control in our series. A total of 2 patients exhibited local recurrence at 30 and 60 months after the second fraction, respectively. No treatment-related complications or new long-term neurological dysfunctions were reported. MRIs observed slightly or moderately increased peritumoral edema in six patients, but no specific neurological complaints are attributed to this finding.

CONCLUSION

This study investigates the efficiency and safety of dose-staged Gamma Knife radiosurgery as an alternative option for meningiomas that were large in volume, adjacent to crucial structures, or in patients with contraindications to craniotomy.

摘要

目的

本研究旨在探讨剂量分期伽玛刀放射外科治疗策略用于大型脑膜瘤或靠近重要神经结构的脑膜瘤的有效性和安全性。

方法

本研究评估了71例连续接受分期剂量分割伽玛刀放射外科治疗的脑膜瘤患者的前瞻性累积系列结果。第一次和第二次分割的平均周边剂量分别为9.0±0.9 Gy（8 - 12 Gy）和8.6±0.7 Gy（范围7 - 10 Gy）。分割之间的间隔为6.1±1.9个月（范围3 - 12个月）。中位随访时间为36个月（12 - 96个月）。

结果

在第二次分割后的随访期间，我们系列中的97.2%实现了肿瘤控制。共有2例患者分别在第二次分割后30个月和60个月出现局部复发。未报告与治疗相关的并发症或新的长期神经功能障碍。MRI观察到6例患者瘤周水肿轻度或中度增加，但未发现与此发现相关的特定神经症状。

结论

本研究探讨了剂量分期伽玛刀放射外科作为体积大、毗邻关键结构或有开颅手术禁忌症的脑膜瘤的替代治疗方案的有效性和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d07/9606413/3a233e05cf82/fneur-13-893480-g0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d07/9606413/4323d8114a02/fneur-13-893480-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d07/9606413/f3107d9d06f8/fneur-13-893480-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d07/9606413/c6760e159431/fneur-13-893480-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d07/9606413/ac3585d9f350/fneur-13-893480-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d07/9606413/3a233e05cf82/fneur-13-893480-g0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d07/9606413/4323d8114a02/fneur-13-893480-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d07/9606413/f3107d9d06f8/fneur-13-893480-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d07/9606413/c6760e159431/fneur-13-893480-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d07/9606413/ac3585d9f350/fneur-13-893480-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d07/9606413/3a233e05cf82/fneur-13-893480-g0005.jpg

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