Cavernous Sinus Meningiomas – What Is the Strategy: Upfront or Adjuvant Gamma Knife Surgery?
Cavernous Sinus Meningiomas – What Is the Strategy: Upfront or Adjuvant Gamma Knife Surgery?
复制标题
海绵窦脑膜瘤 – 策略是什么：预先或辅助伽玛刀手术？
DOI：
10.1159/000056404
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发表时间：
1998
影响因子：
1.7
通讯作者：
K. Feichtinger
中科院分区：
文献类型：
--
作者：
G. Pendl;O. Schröttner;S. Eustacchio;J. C. Ganz;K. Feichtinger
43 名海绵窦脑膜瘤患者构成了本研究的基础。 2 例患者仅接受显微手术治疗，17 例患者以伽玛刀放射治疗（GKRS）作为主要治疗方式，24 例患者接受显微手术和 GKRS 联合治疗。因此，17 名患者的诊断仅依据临床和放射学标准。与开放手术治疗相关的颅神经疾病 (CND) 在该材料中很少见（13 例患者中的 3 例），因为故意采用部分或次全切除策略，旨在使颅神经免受手术操作的影响。相比之下，从其他机构入院接受 GKRS 治疗的 11 名患者中有 6 名在开放手术后出现严重 CND，并且 GKRS 后仅出现部分改善。在所有 GKRS 病例中，经过 18-62 个月（平均 39 个月）的随访后，没有发现与放射相关的并发症。此外，在所有病例中，肿瘤体积稳定（63%）、体积缩小（34.5%）和肿瘤消失（2.5%）得到控制。 GKRS 不仅是累及海绵窦的脑膜瘤的附加治疗方法，而且可以作为患者的替代主要治疗方法。
43 patients with meningiomas of the cavernous sinus form the basis of this study. Two patients were treated with microsurgery alone, 17 patients were treated by Gamma Knife radiosurgery (GKRS) as a primary treatment modality, and 24 patients underwent a combined treatment of microsurgery followed by GKRS. Therefore, in 17 patients the diagnosis rested on clinical and radiological criteria alone. Cranial nerve disorders (CND) related to open surgical treatment were infrequent in this material (3 of 13 patients) due to deliberate strategies of partial or subtotal resection aimed at sparing cranial nerves from surgical maneuvers. In contrast, 6 of 11 patients, admitted for GKRS from other institutions suffered from considerable CND after open surgery and showed only partial improvement after GKRS. In all GKRS cases, no radiation-related complications were seen after a follow-up of 18–62 months (mean 39 months). Moreover, in all cases tumor control was obtained with a stable tumor volume in 63%, reduction of volume in 34.5% and a disappearance of tumor in 2.5%. GKRS is not only an additional treatment for meningiomas involving the cavernous sinus, but may be offered to the patient as an alternative primary treatment.