Radiosurgery for primary malignant brain tumors.
Radiosurgery for primary malignant brain tumors.
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原发性恶性脑肿瘤的放射外科治疗。
DOI：
--
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发表时间：
1998
期刊：
影响因子：
--
通讯作者：
J. Loeffler
中科院分区：
文献类型：
--
作者：
E. Alexander;J. Loeffler
尽管手术、放疗和化疗能够延长多形性胶质母细胞瘤（GBM）患者的生存期，但大多数患者死于疾病，通常是由于局部肿瘤持续存在或复发。立体定向放射外科（SRS）允许在肿瘤细胞密度最大的部位大幅度增加总剂量，同时保留大部分正常大脑，从而显著提高生存率。SRS被设计为一种向小的病灶靶点输送大剂量辐射的技术：其两个标志是剂量的病灶分布和剂量与体积之间的反比关系。SRS的急性并发症与水肿有关，表现为先前存在的症状恶化：癫痫发作、失语症和运动缺陷-这些可以用类固醇治疗，在大多数情况下是短暂的。SRS后12个月和24个月时再次手术的精算风险分别为33%和48%。近距离放射治疗或SRS治疗复发性GBM后的失败模式相似，大多数患者在原始治疗体积外发生边缘失败。小的（直径< 30 mm）、影像学上明显的局灶性复发GBM患者应考虑SRS。较大病变（直径> 30 mm），尤其是邻近功能区皮质或关键白色通路的病变，必须谨慎评估。对于较大的病变，SRS相关急性毒性的可能性大幅增加。在许多胶质瘤患者中使用SRS具有显著的生存优势，特别是如果适当地与手术和其他辅助治疗一起使用。
Despite the ability of surgery, radiotherapy, and chemotherapy to prolong survival in patients with glioblastoma multiforme (GBM), most patients succumb to their disease, usually as a result of local tumor persistence or recurrence. Stereotactic radiosurgery (SRS) allows a substantial increase in total dose at sites of greatest tumor cell density while sparing most of the normal brain, resulting in significantly improved survival. SRS was designed as a technique to deliver a large single dose of radiation to a small and focal target: two of its hallmarks are the focal distribution of dose and the inverse relationship between dose and volume. Acute complications of SRS are related to edema and are manifested as a worsening of pre-existing symptoms: seizure, aphasia, and motor deficits--these are treatable with steroids and are transient in the majority of cases. The actuarial risk of undergoing reoperation was 33% at 12 months and 48% at 24 months, following SRS. Patterns of failure were similar following brachytherapy or SRS as treatment for recurrent GBM with most patients experiencing marginal failure outside the original treatment volume. Patients with small (< 30 mm diameter), radiographically distinct and focally recurrent GBM should be considered for SRS. Larger lesions (> 30 mm diameter), especially those adjacent to eloquent cortex or critical white matter pathways, must be evaluated with caution. The potential for acute toxicity associated with SRS increases substantially for larger lesions. There is a significant survival advantage using SRS in many patients with gliomas, especially if appropriately used with surgery and other adjuvant therapy.
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年龄对接受放射治疗和近距离放射治疗的胶质母细胞瘤患者的生存影响很大。
影响因子：
4.8
作者：
Sneed,PK;Prados,MD;McDermott,MW;Larson,DA;Malec,MK;Lamborn,KR;Davis,RL;Weaver,KA;Wara,WM;Phillips,TL
通讯作者：
Phillips,TL
影响因子：
4.8
作者：
HARSH, GR;LEVIN, VA;WILSON, CB
通讯作者：
WILSON, CB
用放射疗法治疗恶性神经胶质瘤的当代方法。
影响因子：
4
作者：
Leibel,SA;Scott,CB;Loeffler,JS
通讯作者：
Loeffler,JS
用于神经胶质瘤的高活性碘 125 间质植入物。
DOI：
10.1016/0360-3016(92)90702-j
发表时间：
1992
期刊：
International journal of radiation oncology, biology, physics
影响因子：
--
作者：
Scharfen,CO;Sneed,PK;Wara,WM;Larson,DA;Phillips,TL;Prados,MD;Weaver,KA;Malec,M;Acord,P;Lamborn,KR
通讯作者：
Lamborn,KR