Kasper M E, Parsons J T, Mancuso A A, Mendenhall W M, Stringer S P, Cassisi N J, Million R R
Dept. of Radiation Oncology, University of Florida College of Medicine, Gainesville.
Int J Radiat Oncol Biol Phys. 1993 Mar 15;25(4):689-94. doi: 10.1016/0360-3016(93)90017-p.
To provide an analysis of nine patients with juvenile angiofibroma treated with radiotherapy between June 1975 and June 1987.
All patients had a minimum 3 years of follow-up; six of the patients had greater than 5 years and four had greater than 10 years of follow-up. Two patients received radiotherapy as primary therapy, and the remaining seven patients were treated with surgery initially, followed by irradiation for recurrent disease. Characteristic computed tomography (CT), magnetic resonance (MR), and angiography findings were identified. All nine patients had nasal cavity or nasopharyngeal involvement. Eight patients had involvement of the base of the skull, and seven had intracranial extension. Tumor regression during and after treatment was estimated clinically and from available imaging studies.
Tumor regression during treatment ranged from 25% to 100%, with most patients experiencing between 30% and 50% clinical decrease in the size of the tumor. Seven patients eventually showed complete regression by physical examination, but only two of seven patients evaluated by CT and/or MR showed complete regression. In five patients, follow-up imaging studies showed stable residual changes. Local control was achieved in all patients. No late complications were found.
The initial treatment of early lesions is surgical. Low dose irradiation appears to be an effective alternative to extensive surgery in treating advanced juvenile angiofibroma. Morbidity has been minimal. Residual changes are seen in subsequent imaging studies but have remained stable with long follow-up.
对1975年6月至1987年6月间接受放射治疗的9例青少年血管纤维瘤患者进行分析。
所有患者至少随访3年；其中6例患者随访时间超过5年，4例超过10年。2例患者接受放射治疗作为主要治疗方法，其余7例患者最初接受手术治疗，随后对复发性疾病进行放疗。确定了特征性计算机断层扫描（CT）、磁共振（MR）和血管造影结果。所有9例患者均有鼻腔或鼻咽部受累。8例患者累及颅底，7例有颅内扩展。通过临床评估和现有影像学研究估计治疗期间及治疗后的肿瘤消退情况。
治疗期间肿瘤消退率为25%至100%，大多数患者肿瘤大小临床缩小30%至50%。7例患者最终经体格检查显示完全消退，但7例经CT和/或MR评估的患者中只有2例显示完全消退。5例患者的随访影像学研究显示残留改变稳定。所有患者均实现局部控制。未发现晚期并发症。
早期病变的初始治疗为手术治疗。低剂量放疗似乎是治疗晚期青少年血管纤维瘤的有效替代广泛手术的方法。发病率极低。在随后的影像学研究中可见残留改变，但长期随访后保持稳定。
