Kim D G, Paek S H, Kim I H, Chi J G, Jung H W, Han D H, Choi K S, Cho B K
Department of Neurosurgery, Seoul National University College of Medicine, Korea.
Cancer. 1997 May 15;79(10):1995-2002. doi: 10.1002/(sici)1097-0142(19970515)79:10<1995::aid-cncr22>3.0.co;2-p.
It has been suggested that the biologic behavior of central neurocytoma is indolent, although little is known regarding the role of radiation therapy and long term outcome. To clarify the role of radiation therapy and long term outcome, the authors retrospectively analyzed 15 cases of central neurocytoma.
Clinical records and radiologic findings of 15 cases of central neurocytoma diagnosed at Seoul National University Hospital between January 1982 and February 1995 were carefully reviewed. The duration of follow-up was from 18-168 months (mean, 52 months); follow-up images were reviewed and the patient's Karnofsky performance scale (KPS) was assessed up to the time of last follow-up.
The age of the patients ranged from 15 to 60 years (mean, 25 years) and the male to female ratio was 11:4. Macroscopic total resection of the tumor was performed in seven patients, two of whom received fractionated radiation therapy. Subtotal removal of the tumor was performed in eight patients, five of whom received this same therapy. In 2 of the 5 patients who did not receive radiation therapy after macroscopic total resection, the tumors recurred 8 and 21 months after surgery, respectively; in contrast, recurrence was not detected in the 2 patients who received fractionated radiation therapy after macroscopic total resection. In all five patients who received fractionated radiation therapy after subtotal resection, the tumor shrank (n = 3) or disappeared (n = 2) during the postsurgical follow-up period ranging from 27-113 months; the tumor began to shrink from 6 months to 2 years after radiation. No change was found in the three patients who did not receive radiation therapy after subtotal resection. At the time of last follow-up, the KPS was greater than 90 in all patients except one who required assistance in his daily activities because of complications from radiation therapy.
It is suggested that even if the biologic behavior of a central neurocytoma is benign, radiation therapy appears to have an effect on tumor control. However, it should be carefully decided whether to use radiation therapy for a residual tumor because radiation can cause delayed complications and the clinical course of subtotally resected patients who do not receive radiation therapy is extremely benign.
尽管对于放射治疗的作用及长期预后了解甚少，但有观点认为中枢神经细胞瘤的生物学行为是惰性的。为阐明放射治疗的作用及长期预后，作者回顾性分析了15例中枢神经细胞瘤病例。
仔细回顾了1982年1月至1995年2月在首尔国立大学医院诊断的15例中枢神经细胞瘤的临床记录和影像学检查结果。随访时间为18至168个月（平均52个月）；复查随访影像，并评估患者至最后随访时的卡氏功能状态评分（KPS）。
患者年龄为15至60岁（平均25岁），男女比例为11:4。7例患者进行了肿瘤肉眼全切，其中2例接受了分次放射治疗。8例患者进行了肿瘤次全切除，其中5例接受了同样的治疗。在5例肉眼全切后未接受放射治疗的患者中，有2例分别在术后8个月和21个月肿瘤复发；相比之下，肉眼全切后接受分次放射治疗的2例患者未检测到复发。在次全切除后接受分次放射治疗的所有5例患者中，在术后27至113个月的随访期内，肿瘤缩小（n = 3）或消失（n = 2）；放射治疗后6个月至2年肿瘤开始缩小。次全切除后未接受放射治疗的3例患者未见变化。在最后随访时，除1例因放射治疗并发症在日常生活中需要帮助的患者外所有患者的KPS均大于90。
提示即使中枢神经细胞瘤的生物学行为是良性的，放射治疗似乎对肿瘤控制有作用。然而，对于残留肿瘤是否使用放射治疗应谨慎决定，因为放射治疗可导致延迟并发症，且次全切除后未接受放射治疗患者的临床病程极为良性。
