EXPERIENCE IN CHARGED-PARTICLE IRRADIATION OF TUMORS OF THE SKULL BASE - 1977-1992
EXPERIENCE IN CHARGED-PARTICLE IRRADIATION OF TUMORS OF THE SKULL BASE - 1977-1992
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DOI：
10.1016/0360-3016(94)90550-9
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发表时间：
1994-07-01
影响因子：
7
通讯作者：
PHILLIPS, TL
中科院分区：
文献类型：
--
作者：
CASTRO, JR;LINSTADT, DE;PHILLIPS, TL
目的：回顾加州大学劳伦斯伯克利实验室使用带电粒子照射颅底原发肿瘤以及从鼻咽和鼻窦向颅底延伸肿瘤的经验。方法和材料：1977年至1992年期间，劳伦斯伯克利实验室对223例颅底肿瘤患者进行了带电粒子照射，其中48例（22%）在既往手术或放疗后复发。126例患者有颅底病变，主要是脊索瘤（53例）、软骨肉瘤（27例）、门旁脑膜瘤（27例），19例患者有其他组织学，如骨肉瘤或神经纤维肉瘤。原发性或复发性鼻咽部鳞状癌延伸至颅底31例，大小唾液腺肿瘤44例，以腺癌居多，鼻窦鳞状癌22例，均颅底延伸。结果：颅底肿瘤的局部控制和生存得到改善，因为带电粒子能够提供高剂量（平均65 gy当量），而邻近正常组织相对较少。Kaplan-Meier 5年局部对照组脑膜瘤为85%，软骨肉瘤为78%，脊索瘤为63%，其他肉瘤为58%。随访4-191个月，中位51个月。结论：带电粒子放疗是治疗颅底部分切除病变的有效方法。CT和MRI更好的肿瘤定位，改进的三维治疗计划和光束输送技术继续降低严重并发症的水平，增加局部控制和生存。
Purpose: To review the experience at University of California Lawrence Berkeley Laboratory in using charged particles to irradiate primary neoplasms of the skull base and those extending to the skull base from the nasopharynx and paranasal sinuses.Methods and Materials: During the period from 1977 to 1992, 223 patients were irradiated with charged particles at the Lawrence Berkeley Laboratory for tumors either arising in or extending to the skull base, of whom 48 (22%) had recurrent lesions, either post previous surgery or radiotherapy. One hundred twenty-six patients had lesions arising in the cranial base, mostly chordoma (53), chondrosarcoma (27), paraclival meningioma (27) with 19 patients having other histologies such as osteosarcoma or neurofibrosarcoma. There were also 31 patients with primary or recurrent squamous carcinoma of the nasopharynx extending to the skull base, 44 patients with major or minor salivary gland tumors, mostly adenocarcinoma, and 22 patients with squamous carcinoma of the paranasal sinuses, all with cranial base extension.Results: Local control and survival appeared improved in tumors arising in the skull base, following the ability with charged particles to deliver high doses (mean of 65 Gy-equivalent) with relative sparing of the adjacent normal tissues. The Kaplan-Meier 5-year local control was 85% for meningioma, 78% for chondrosarcoma, 63% for chordoma and 58% for other sarcoma. Follow-up ranged from 4-191 months with a median of 51 months.Conclusion: Charged particle radiotherapy is highly effective ire controlling cranial base lesions which have have been partially resected. Better tumor localization with CT and MRI, improved 3-D treatment planning and beam delivery techniques have continued to reduce the level of serious complications and increase local control and survival.