Tumor control and hearing preservation after Gamma Knife radiosurgery for vestibular schwannomas in neurofibromatosis type 2
Tumor control and hearing preservation after Gamma Knife radiosurgery for vestibular schwannomas in neurofibromatosis type 2
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DOI：
10.1007/s11060-010-0181-1
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发表时间：
2010-06-01
影响因子：
3.9
通讯作者：
Mahapatra, Ashok Kumar
中科院分区：
文献类型：
--
作者：
Sharma, Manish Singh;Singh, Rakesh;Mahapatra, Ashok Kumar
为分析伽玛刀放射外科(GKS)对前庭神经鞘瘤(VS)患者的肿瘤控制和听力保留率的影响，在三级转诊伽玛刀病房进行了一项回顾性研究。本文回顾了1997-2008年间使用Leksell伽玛刀(瑞典斯德哥尔摩Elekta Instruments AB)B型刀进行VS GKS治疗的NF2患者的剂量计划、术前和术后放射学及随访临床记录。30例54个VS患者接受了GKS。队列的平均年龄为29岁(10-56岁)。24例患者有双侧VS。最常见的临床表现是听力损失和耳鸣。36个肿瘤接受了初级GKS，18个肿瘤作为手术辅助接受了GKS。肿瘤平均大小为3.7cc(0.1~13.3cc)。在50%等剂量(范围42-50%)下，处方剂量的中位数为12GY(范围10-15GY)，以覆盖平均91.5%的肿瘤。18名患者可用于临床，14名患者可用于放射检查，5名患者可用于听力测量，平均随访时间为26.6个月。肿瘤控制率为87.5%(肿瘤消退33.3%)，听力保留率为66.7%。1例患者面部功能恶化。对于患有NF2的患者，GKS为VS提供了令人满意的肿瘤控制和听力保护。长期随访将决定未来的建议。
To analyze the effect of Gamma Knife radiosurgery (GKS) on tumor control and hearing preservation rates in patients with vestibular schwannomas (VS) in a setting of neurofibromatosis type 2 (NF 2), a retrospective study was carried out at a tertiary-level referral Gamma Knife unit. Dose plans, pre-and postoperative radiology, and follow-up clinical records of patients with NF 2 who had undergone GKS for VS using a Leksell Gamma Knife (Elekta Instruments AB, Stockholm, Sweden) model B unit from 1997 to 2008 were reviewed. Thirty patients with 54 VS underwent GKS. The average age of the cohort was 29 years (range 10-56 years). Twenty-four patients had bilateral VS. The commonest clinical presentation was hearing loss and tinnitus. Primary GKS was given to 36 tumors, while 18 tumors received it as an adjunct to surgery. Average tumor size was 3.7 cc (range 0.1-13.3 cc). A median 12 Gy prescription dose (range 10-15 Gy) was administered at the 50% isodose (range 42-50%) to cover on average 91.5% of the tumor. Eighteen patients were available for clinical, 14 patients for radiological, and 5 patients (with useful hearing) for audiometric follow-up at an average of 26.6 months. The tumor control rate was 87.5% in this series (33.3% tumor regression), while hearing preservation was noted in 66.7% of cases. One patient developed worsening of facial function. GKS for VS provides satisfactory tumor control and hearing preservation in patients with NF 2. Long-term follow-up will determine future recommendations.