Radiation necrosis or glioma recurrence: is computer-assisted stereotactic biopsy useful?
Radiation necrosis or glioma recurrence: is computer-assisted stereotactic biopsy useful?
复制标题
放射性坏死或神经胶质瘤复发：计算机辅助立体定向活检有用吗？
作者：
P. Forsyth;P. Kelly;T. Cascino;B. Scheithauer;E. Shaw;R. Dinapoli;E. Atkinson
Fifty-one patients with supratentorial glioma treated with external beam radiotherapy (median dose 59.5 Gy) who then demonstrated clinical or radiographic evidence of disease progression underwent stereotactic biopsy to differentiate tumor recurrence from radiation necrosis. The original tumor histological type was diffuse or fibrillary astrocytoma in 21 patients (41%), oligodendroglioma in 13 (26%), and oligoastrocytoma in 17 (33%); 40 tumors (78%) were low-grade (Kernohan Grade 1 or 2). The median time to suspected disease progression was 28 months. Stereotactic biopsy showed tumor recurrence in 30 patients (59%), radiation necrosis in three (6%), and a mixture of both in 17 (33%); one patient (2%) had a parenchymal radiation-induced chondroblastic osteosarcoma. The tumor type at stereotactic biopsy was similar to the original tumor type and was astrocytoma in 24 patients (47%), oligodendroglioma in eight (16%), oligoastrocytoma in 16 (31%), unclassifiable in two (4%), and chondroblastic osteosarcoma in one patient (2%). At biopsy, however, only 19 tumors (37%) were low grade (Kernohan Grade 1 or 2). Subsequent surgery confirmed the stereotactic biopsy histological findings in eight patients. Follow-up examination showed 14 patients alive with a median survival of 1 year for the entire group. Median survival times after biopsy were 0.83 year for patients with tumor recurrence and 1.86 years for patients with both tumor recurrence and radionecrosis; these findings were significantly different (p = 0.008, log-rank test). No patient with radiation necrosis alone died. Other factors associated with reduced survival were a high proportion of residual tumor (p = 0.024), a low proportion of radionecrosis (p < 0.001), and a Kernohan Grade of 3 or 4 (p = 0.005). In conclusion, in patients with previously irradiated supratentorial gliomas in whom radionecrosis or tumor recurrence was clinically or radiographically suspected, results of stereotactic biopsy could be used to differentiate tumor recurrence, radiation necrosis, a mixture of both lesions, or radiation-induced neoplasm. In addition, biopsy results could predict survival rates.
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间质照射和热疗用于治疗复发性恶性脑肿瘤。
影响因子：
4.8
作者：
Sneed,PK;Stauffer,PR;Gutin,PH;Phillips,TL;Suen,S;Weaver,KA;Lamb,SA;Ham,B;Prados,MD;Larson,DA
通讯作者：
Larson,DA
间质近距离放射治疗后恶性脑肿瘤的 PET。
影响因子：
4.1
作者：
Valk,PE;Budinger,TF;Levin,VA;Silver,P;Gutin,PH;Doyle,WK
通讯作者：
Doyle,WK
利用 Gildenberg 技术进行计算机断层扫描引导的立体定向活检的更多经验。
影响因子：
4.8
作者：
Bullard,DE;Osborne,D;Burger,PC;NasholdJr,BS
通讯作者：
NasholdJr,BS
影响因子：
4.1
作者：
BREM, H;MAHALEY, S;KENEALY, JN
通讯作者：
KENEALY, JN