Kida Y, Kobayashi T, Tanaka T, Oyama H, Niwa M
Department of Neurosurgery, Komaki City Hospital.
No Shinkei Geka. 1995 Aug;23(8):671-5.
A new treatment strategy for jugular foramen tumors using radiosurgery is reported. Six jugular foramen tumors, including 2 glomus tumors and 4 lower cranial neurinomas, were involved. Among them only one tumor was confined in the jugular foramen, but the others extended into the posterior fossa, the upper cervical portion or both. As an initial treatment, 3 cases underwent operative resection from suboccipital or transcervical route. The tumor sizes at radiosurgery ranged from 14.3 to 36.1 mm with a mean of 22.4 mm in diameter. They were treated with a marginal dose between 13 to 16.5 Gy (mean 15.6 Gy). Follow-up MRI showed an apparent tumor shrinkage in 4 and no change in 2. Central tumor necrosis was found in 4 cases, but tumor progression was never observed in the mean follow-up period of 19 months. No complication occurred during and after the radiosurgery. These results indicate that radiosurgery is effective for the control of jugular foramen tumors with acceptable risk. Large tumors extending to the upper cervical portion and posterior fossa can be treated by operative resection combined with radiosurgery.
本文报道了一种使用放射外科治疗颈静脉孔区肿瘤的新策略。纳入了6例颈静脉孔区肿瘤，包括2例颈静脉球瘤和4例下颅神经鞘瘤。其中仅1例肿瘤局限于颈静脉孔内，其他肿瘤则延伸至后颅窝、上颈部或两者。作为初始治疗，3例患者接受了枕下或经颈入路的手术切除。放射外科治疗时肿瘤大小直径范围为14.3至36.1mm，平均为22.4mm。给予边缘剂量13至16.5Gy（平均15.6Gy）进行治疗。随访MRI显示4例肿瘤明显缩小，2例无变化。4例出现肿瘤中央坏死，但在平均19个月的随访期内未观察到肿瘤进展。放射外科治疗期间及治疗后均未发生并发症。这些结果表明，放射外科治疗颈静脉孔区肿瘤有效且风险可接受。延伸至上颈部和后颅窝的大型肿瘤可通过手术切除联合放射外科治疗。
