Results of radiosurgery in the management of recurrent and residual medulloblastoma.
Results of radiosurgery in the management of recurrent and residual medulloblastoma.
复制标题
DOI：
10.1159/000120901
复制
发表时间：
1995
影响因子：
0.7
通讯作者：
S. Patrice;N. Tarbell;Liliana C. Goumnerova;D. Shrieve;P. M. Black;J. S. Loeffler
中科院分区：
文献类型：
--
作者：
S. Patrice;N. Tarbell;Liliana C. Goumnerova;D. Shrieve;P. M. Black;J. S. Loeffler
1989年6月至1994年1月，14例复发（n = 11）或治疗后残留（n = 3）髓母细胞瘤患者参加了一个程序，以评估立体定向放射外科（SR）的疗效和毒性。初步治疗包括12例次全手术切除和2例完全手术切除。13例患者接受了全身化疗，所有患者在SR前均接受了颅脊髓照射。SR被用作3例患者（3个肿瘤）治疗后残留疾病的增强部位的技术，并在11例放射学明确的离散复发肿瘤患者（14个肿瘤）中用作挽救治疗。患者在完成颅脊髓照射后1-97（中位数20）个月接受SR。中位最小外周肿瘤剂量为12戈伊。SR时的中位肿瘤体积为6.9 cm 3。从诊断开始的中位随访期为27（范围8-39）个月，所有接受SR作为残留病变部位加强治疗的患者均存活，无疾病证据。相比之下，11例接受SR治疗复发性疾病的患者中有6例死于进行性髓母细胞瘤。复发性疾病治疗患者从SR开始的中位生存期为10个月（范围5-59+）。SR后失败的主要部位在中枢神经系统内，6例患者（43%）在后颅窝外失败。没有患者在放射外科靶体积内局部失败。2例患者（14%）发生边缘复发。（250字处删节）
Between June 1989 and January 1994, 14 patients with recurrent (n = 11) or posttreatment residual (n = 3) medulloblastoma were enrolled in a program to evaluate the efficacy and toxicity of stereotactic radiosurgery (SR). Initial treatment consisted of subtotal surgical resection in 12 patients and complete surgical resection in 2. Thirteen patients received systemic chemotherapy, and all had craniospinal irradiation prior to SR. SR was used as a technique for boosting sites of posttreatment residual disease in 3 patients (3 tumors) and as salvage therapy in 11 patients (14 tumors) with radiographically well-defined, discrete recurrent tumors. Patients underwent SR 1-97 (median 20) months after completing craniospinal irradiation. The median minimum peripheral tumor dose was 12 Gy. The median tumor volume at the time of SR was 6.9 cm3. With a median follow-up period from diagnosis of 27 (range 8-39) months, all patients treated with SR as a boost to sites of residual disease are alive without evidence of disease. In contrast, 6 of 11 patients who underwent SR for treatment of recurrent disease have died of progressive medulloblastoma. The median survival from the time of SR for patients treated for recurrent disease was 10 (range 5-59+) months. The predominant site of failure after SR was distant within the central nervous system, with 6 patients (43%) failing outside the posterior fossa. No patient failed locally within the radiosurgical target volume. Two patients (14%) developed marginal recurrences.(ABSTRACT TRUNCATED AT 250 WORDS)