Linear accelerator radiosurgery for recurrent malignant tumors of the skull base
Linear accelerator radiosurgery for recurrent malignant tumors of the skull base
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DOI：
10.1097/00000421-199802000-00004
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发表时间：
1998-02-01
影响因子：
2.6
通讯作者：
Mueller, RP
中科院分区：
文献类型：
--
作者：
Kocher, M;Voges, J;Mueller, RP
评估了基于直线加速器的放射外科手术对预照射复发鼻咽癌和侵犯颅底的不可切除复发肉瘤患者的疗效。 13 名患者接受了治疗：8 名患者患有鼻咽癌（淋巴上皮瘤，4 名；鳞状细胞癌，2 名；腺样囊性癌，2 名）； 5 名患者患有肉瘤（横纹肌肉瘤，1 例；脊索瘤，1 例；软骨肉瘤，1 例；血管外皮细胞瘤，2 例）。所有患者都接受了重复的肿瘤切除或放射治疗，阻碍了任何进一步的常规分割放射治疗或手术。使用改进的直线加速器（8-MeV 光子）进行会聚光束照射。由于肿瘤结构不规则，13 名患者中的 10 名必须使用多个（最多 7 个）等中心，以使靶体积与参考等剂量 (60%-80%) 相匹配。每个等角点用 6 至 10 个弧进行照射。中位计划靶体积为 33 mt (4-128 mt)，中位剂量为 15 Gy (9-24 Gy)。 8名复发鼻咽癌患者的中位生存时间为9个月，3名肿瘤完全或部分缓解的患者生存了1.5至3.5年。所有肉瘤患者均对放射外科治疗有反应。经过 28 至 67 个月的随访，5 名患者中有 4 名存活。这项研究表明，放射外科手术是对经过广泛预处理的复发性鼻咽癌患者进行姑息治疗的有效工具。颅底肉瘤复发的患者可以接受长期姑息治疗，甚至治愈。
The efficacy of linear accelerator-based radiosurgery for patients who have preirradiated recurrent nasopharyngeal carcinomas and unresectable recurrent sarcomas invading the base of skull was assessed. Thirteen patients were treated: 8 patients had carcinomas arising from the nasopharynx (lymphoepithelioma, 4; squamous cell carcinoma, 2; adenoid-cystic, 2); 5 patients had sarcomas (rhabdomyosarcoma, 1; chordoma, 1; chondrosarcoma, 1; hemangiopericytoma, 2). All patients had had repeated tumor resections or irradiation, hindering any further conventional fractionated radiotherapy or surgery. Convergent-beam irradiation was performed with a modified linear accelerator (8-MeV photons). Because of irregular tumor configuration, multiple (up to seven) isocenters had to be used in 10 of 13 patients to match the target volume with the reference isodose (60%-80%). Each isocenter was irradiated with 6 to 10 arcs. The median planning target volume was 33 mt (4-128 mt) and the median dose was 15 Gy (9-24 Gy). Median survival time was 9 months in 8 patients who had recurrent nasopharyngeal carcinomas, Three patients who had complete or partial tumor remission survived 1.5 to 3.5 years. All of the sarcoma patients responded to radiosurgery. After a follow-up of 28 to 67 months, 4 of 5 patients are alive. This investigation demonstrates that radiosurgery is an effective tool in palliative treatment for patients who have recurrent, extensively pretreated nasopharyngeal cancer. Patients who have recurrent sarcomas of the base of skull may be treated for long-term palliation or even for cure.