基于立体定向放射外科治疗嗅神经母细胞瘤继发的脑远距离转移瘤：单中心研究系列

Stereotactic radiosurgery for distant brain metastases secondary to esthesioneuroblastoma: a single-institution series.

机构信息

Departments of1Neurosurgery and.

2Radiation Oncology, Stanford University School of Medicine, Stanford, California.

出版信息

Neurosurg Focus. 2023 Aug;55(2):E6. doi: 10.3171/2023.5.FOCUS23216.

DOI:10.3171/2023.5.FOCUS23216

PMID:37527675

Abstract

OBJECTIVE

Esthesioneuroblastoma (ENB), also known as olfactory neuroblastoma, is a rare, malignant tumor of neuroectodermal origin that arises from the olfactory neuroepithelium. In this study the authors present the first series in the literature on distant brain metastases (BMs) secondary to ENB that were treated with stereotactic radiosurgery (SRS), to evaluate the safety and effectiveness of SRS for this indication.

METHODS

A retrospective analysis of clinical and radiological outcomes of patients with ENB who underwent CyberKnife (CK) SRS at a single center was conducted. The clinical and radiological outcomes of patients, including progression-free survival, overall survival, and local tumor control (LTC) were reported.

RESULTS

Between 2003 and 2022, 32 distant BMs in 8 patients were treated with CK SRS at Stanford University. The median patient age at BM diagnosis was 62 years (range 47-75 years). Among 32 lesions, 2 (6%) had previously been treated with surgery, whereas for all other lesions (30 [94%]), CK SRS was used as their primary treatment modality. The median target volume was 1.5 cm3 (range 0.09-21.54 cm3). CK SRS was delivered by a median marginal dose of 23 Gy (range 15-30 Gy) and a median of 3 fractions (range 1-5 fractions) to a median isodose line of 77% (range 70%-88%). The median biologically effective dose was 48 Gy (range 21-99.9 Gy) and the median follow-up was 30 months (range 3-95 months). The LTC at 1-, 2-, and 3-year follow-up was 86%, 65%, and 50%, respectively. The median progression-free survival and overall survival were 29 months (range 11-79 months) and 51 months (range 15-79 months), respectively. None of the patients presented adverse radiation effects.

CONCLUSIONS

In the authors' experience, SRS provided excellent LTC without any adverse radiation effects for BMs secondary to ENB.

摘要

目的

嗅神经母细胞瘤（ENB），也称为嗅神经母细胞瘤，是一种罕见的、源自神经外胚层的恶性肿瘤，起源于嗅神经上皮。在这项研究中，作者报告了文献中首例因嗅神经母细胞瘤而发生的远处脑转移瘤（BM），并采用立体定向放射外科（SRS）治疗，以评估 SRS 治疗该疾病的安全性和有效性。

方法

对在单一中心接受 CyberKnife（CK）SRS 治疗的 ENB 患者的临床和放射学结果进行回顾性分析。报告了患者的临床和放射学结果，包括无进展生存期、总生存期和局部肿瘤控制率（LTC）。

结果

2003 年至 2022 年期间，斯坦福大学共对 8 例患者的 32 个远处 BM 采用 CK SRS 治疗。BM 诊断时患者的中位年龄为 62 岁（范围 47-75 岁）。32 个病灶中，有 2 个（6%）先前曾接受过手术治疗，而对于所有其他病灶（30 个[94%]），CK SRS 是其主要治疗方式。中位靶体积为 1.5cm3（范围 0.09-21.54cm3）。CK SRS 的中位边缘剂量为 23Gy（范围 15-30Gy），中位分割次数为 3 次（范围 1-5 次），中位等剂量线为 77%（范围 70%-88%）。中位生物有效剂量为 48Gy（范围 21-99.9Gy），中位随访时间为 30 个月（范围 3-95 个月）。1、2 和 3 年 LTC 分别为 86%、65%和 50%。中位无进展生存期和总生存期分别为 29 个月（范围 11-79 个月）和 51 个月（范围 15-79 个月）。无患者出现放射不良反应。