Malignant progression of benign brain tumors after gamma knife radiosurgery: Is it really caused by irradiation?
Malignant progression of benign brain tumors after gamma knife radiosurgery: Is it really caused by irradiation?
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DOI：
10.1055/s-2005-915632
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发表时间：
2005-12-01
影响因子：
--
通讯作者：
Takakura, K
中科院分区：
文献类型：
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作者：
Kubo, O;Chernov, M;Takakura, K
放射外科手术后良性肿瘤恶变的诊断通常基于良性肿瘤的最初存在、其暴露于电离辐射、从辐射暴露到恶性进展的经过时间以及再生肿瘤与最初治疗的肿瘤相比的不同组织学特征或生长速度。三个提出的病例符合这些诊断标准；然而，肿瘤（神经鞘瘤、脑膜瘤、脊索瘤）的进展似乎是疾病自然病程的结果，而不是伽马刀放射外科手术的副作用。在放射外科治疗前直接评估良性肿瘤的增殖潜力（如果有肿瘤取样），或通过计算肿瘤生长速率和/或分析代谢成像（PET、MRS）数据间接评估良性肿瘤的增殖潜力，对于识别“侵袭性”亚型、精确预测预后以及确认肿瘤再生情况下放射诱导的恶性转化非常重要。
Malignant transformation of benign neoplasm after radiosurgery is usually diagnosed based on the initial presence of benign tumor, its exposure to ionizing radiation, elapsed time from radiation exposure to malignant progression, and different histological characteristics or growth rate of the regrowing tumor comparing with those originally treated. Three presented cases fulfilled these diagnostic criteria; however, it seems that progression of the tumors (schwannoma, meningioma, chordoma) resulted from the natural course of the disease, rather than represented side effects of gamma knife radiosurgery. Evaluation of the proliferative potential of the benign neoplasm before radiosurgical treatment either directly, if tumor sampling is available, or indirectly, by calculation of the tumor growth rate and/or analysis of the data of the metabolic imaging (PET, MRS) is important for identification of "aggressive" subtypes, precise prediction of prognosis, and confirmation of the radiation-induced malignant transformation in cases of tumor regrowth.