Stereotactic radiosurgery for pilocytic astrocytomas part 2: outcomes in pediatric patients
Stereotactic radiosurgery for pilocytic astrocytomas part 2: outcomes in pediatric patients
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DOI：
10.1007/s11060-009-9912-6
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发表时间：
2009-11-01
影响因子：
3.9
通讯作者：
Lunsford, L. Dade
中科院分区：
文献类型：
--
作者：
Kano, Hideyuki;Niranjan, Ajay;Lunsford, L. Dade
评估儿童患者新诊断或复发毛细胞星形细胞瘤立体定向放射外科 (SRS) 后的结果。 1987 年至 2006 年间，50 名幼年毛细胞星形细胞瘤 (JPA) 患者（28 名男性和 22 名女性）接受了伽玛刀 SRS 治疗。患者中位年龄为 10.5 岁（范围为 4.2-17.9 岁）。三名患者之前的分割放射治疗 (RT) 失败，两名患者 RT 和化疗失败。中位放射外科靶体积为 2.1 cc（范围，0.17-14.4 cc），中位边缘剂量为 14.5 Gy（范围，11-22.5 Gy）。中位随访时间为 55.5 个月（范围 6.0-190 个月），其中 1 名患者死亡，49 名患者存活。整个系列的 SRS（包括肿瘤生长和囊肿扩大）后 1 年、3 年和 5 年无进展生存率分别为 91.7%、82.8% 和 70.8%。当切除不可行或早期复发时，应考虑对儿童毛细胞星形细胞瘤进行立体定向放射外科治疗。在小体积残留实体瘤中观察到最佳反应。
To assess outcomes after stereotactic radiosurgery (SRS) for newly diagnosed or recurrent pilocytic astrocytomas in pediatric patients. Fifty patients (28 male and 22 females) with juvenile pilocytic astrocytomas (JPA) underwent Gamma knife SRS between 1987 and 2006. The median patient age was 10.5 years (range, 4.2-17.9 years). Three patients had failed prior fractionated radiation therapy (RT) and two had failed RT and chemotherapy. The median radiosurgery target volume was 2.1 cc (range, 0.17-14.4 cc) and the median margin dose was 14.5 Gy (range, 11-22.5 Gy). At a median follow-up of 55.5 months (range 6.0-190 months), one patient died and 49 were alive. The progression free survival after SRS (including tumor growth and cyst enlargement) for the entire series was 91.7, 82.8 and 70.8% at 1, 3 and 5 years, respectively. Stereotactic radiosurgery for pediatric pilocytic astrocytomas should be considered when resection is not feasible, or if there is an early recurrence. The best response was observed in small volume residual solid tumors.