Analysis of biological effect and clinical result of radiosurgery

放射外科的生物学效应及临床结果分析

• 批准号: 05671146
• 负责人: SUZUKI Ichiro
• 金额: $ 1.41万
• 依托单位: University of Tokyo
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1993
• 资助国家: 日本
• 起止时间: 1993 至 1995
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-05671146/
• 关键词: Gamma knife; radiosurgery; biological effect; clinical results; acoustic tumor; arteriovenous malformation; meningioma; 神経細胞; 生物学的影響; アポトーシス; γナイフ(ガンマナイフ); radiosurgery; AUM(動静脈奇型); 脳腫瘍

Radiosurgery is closed-skull destruction of a precisely defined intracranial target using ionizing irradiation. Compared to conventional fractionated radiotherapy, the biological effect of radiosurgery on each of pathological entities are not well known. In order to analyze the factors influencing the clinical results of radiosurgery, we evaluate the technique, and treatment parameters of consecutive 562 patients who underwent gamma knife radiosurgery between June 1990 and February 1996. Concerning cerebral arteriovenous malformations (AVMs), the lesion volume has been believed to be the primary factor influencing the obliteration rate. We found the rate does not depend on the volume under dose planning with precise 3-D information. However, radiation-induced brain edema occurred in proportion with treatment volume. Radiation-induced neurological deterioration was mainly depends on the location of the lesions. Concerning intracranial benign tumors, such as acoustic neurinomas or meningiomas, neoplasmic progression was observed only 7-9% after radiosurgery. Treatment-associated neurological morbidity of skull base tumors, especially, hearing preservatio rate in patients with acoustic neurinomas, was significantly better than microsurgical resection. In conclusion, sterotactic radiosrugery prove to be a effective and less invasive managment of selected cerebral AVMs and small benign brain tumors. However, longer follow-up and more detailed analysis of clinical outcome must be required to testify the future expanding role of this technique.

放射外科是使用电离辐射对精确定义的颅内目标进行闭合颅骨破坏。与传统的分割放射治疗相比，放射外科对每种病理实体的生物学效应尚不清楚。为了分析影响放射外科临床效果的因素，我们对1990年6月至1996年2月连续562例接受伽玛刀放射外科手术的患者的技术和治疗参数进行了评估。对于脑动静脉畸形（AVM），病灶体积被认为是影响闭塞率的主要因素。我们发现该比率并不取决于具有精确 3D 信息的剂量计划下的体积。然而，辐射引起的脑水肿的发生与治疗量成正比。放射线引起的神经功能恶化主要取决于病变部位。对于颅内良性肿瘤，例如听神经瘤或脑膜瘤，放射外科手术后仅观察到 7-9% 的肿瘤进展。颅底肿瘤的治疗相关神经系统发病率，尤其是听神经鞘瘤患者的听力保留率，明显优于显微手术切除。总之，立体定向放射治疗被证明是对选定的脑动静脉畸形和小型良性脑肿瘤的有效且侵入性较小的治疗方法。然而，必须需要更长时间的随访和更详细的临床结果分析来证明该技术未来扩大的作用。

项目成果

Ito k, Kurita H, Sasaki T et al: "Neuro-otological findings after gamma knife radiosurgery in acoustic neurinomas" otolarngol Head and Neck Surg. (in press).

Ito k、Kurita H、Sasaki T 等人：“听神经瘤伽玛刀放射外科治疗后的神经耳科发现”耳鼻喉头颈外科。

Ito K,Kurita H,Sasaki T,et al.: "Neuro-otological findings after gamma knife radiosurgery in acoustic neurinomas." Otolaryngol Head and Neck Surg. (in press).

Ito K、Kurita H、Sasaki T 等人：“听神经瘤伽玛刀放射外科手术后的神经耳科发现。”

河本俊介.佐々木富男: "Gamma KnifeによるStereotactic Radiosurgery" 神経内科. 38. 192-204 (1993)

Shunsuke Kawamoto. Tomio Sasaki：“伽玛刀立体定向放射外科”神经病学。 38. 192-204 (1993)

Kawamoto,S.et.al.: "Crebrcvascular Surgery" Stereotactic radiosurgery for cerebral arteriovenous malformations, 4 (1994)

Kawamoto,S.et.al.：“脑血管外科”立体定向放射外科治疗脑动静脉畸形，4 (1994)

Kurita H, et al.: "Chronic encapsulated expanding hematoma in association with gamma knife radiosurgery for cerebral arteriovenous malformation." Journal of Neurosurgery. (in press).

Kurita H 等人：“与伽玛刀放射外科治疗脑动静脉畸形相关的慢性包裹性扩张血肿。”