Nagane M, Shibui S, Oyama H, Nomura K, Sumi M, Tokuuye K, Akine Y
Department of Neurosurgery, National Cancer Center Hospital, Tokyo, Japan.
J Neurooncol. 1995 Oct;26(1):79-86. doi: 10.1007/BF01054772.
We present a 24-year-old woman with multifocal and heterochronous recurrence of malignant astrocytomas that were consecutively treated by linac-based sterotactic radiotherapy. The patient had previously received multimodalities of treatment for malignant astrocytomas in the right occipital lobe consisting of surgical resection on four occasions, conventional external-beam irradiation, immunological therapy, and systemic chemotherapy. Thereafter she developed relatively small and well-demarcated recurrent lesions in eight different sites, most of which were located in eloquent and deep-seated regions. She underwent ten fractionated linac-based stereotactic radiotherapy courses with a median total dose of 42 Gy, seven fractions of 6 Gy each in 15 days, experiencing neither any adverse effects nor neurologic deterioration. Three out of 10 treated lesions responded well with subsequent reduction in size, and 80% of them did not increase at least for 6 months, although 66.7% of the lesions eventually exhibited enlargement of the enhanced areas, some of which were presumed as radiation necrosis. These clinical results suggest that the fractionated linac-based stereotactic radiotherapy had significant effects on tumor growth inhibition and attainment of acceptable patient performance status.
我们报告一名24岁女性，患有多灶性、异时性复发性恶性星形细胞瘤，先后接受了基于直线加速器的立体定向放射治疗。该患者此前曾对右枕叶恶性星形细胞瘤进行过多种治疗，包括4次手术切除、常规外照射、免疫治疗和全身化疗。此后，她在8个不同部位出现了相对较小且边界清晰的复发病变，其中大多数位于功能区和深部区域。她接受了10次基于直线加速器的立体定向放射治疗，中位总剂量为42 Gy，分15天给予7次，每次6 Gy，未出现任何不良反应或神经功能恶化。10个治疗病变中有3个反应良好，随后体积缩小，其中80%至少6个月未增大，尽管66.7%的病变最终增强区域出现增大，部分被推测为放射性坏死。这些临床结果表明，基于直线加速器的分次立体定向放射治疗对肿瘤生长抑制和使患者达到可接受的功能状态具有显著效果。
