伽玛刀放射治疗作为一种可靠、有效的治疗方法:单一机构的长期经验和文献综述

Raef F.A. Hafez
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摘要

目的:颈静脉球瘤(Glomus jugulare tumor, GJTs)是一种生长缓慢、高度血管化的良性肿瘤,具有浸润神经血管结构的潜力。手术治疗通常伴随着高发病率甚至死亡。伽玛刀放射手术(GKRS)已被确定为一种有效的治疗选择。本回顾性研究旨在报道和证实GKRS。对于GJT患者的长期有效性和安全性。方法:2005 - 2020年在作者中心接受GKRS治疗的65例GJTs患者,平均随访时间87.7个月。治疗后GJT平均体积为5.4cc,处方中位剂量为15Gy,最大中位剂量为42.9Gy。结果:大多数患者为女性(77%),就诊时中位年龄为48岁。61例患者肿瘤生长总体控制率为93.8%,其中39%的患者肿瘤缩小。临床总控制率为90.8%(59例),临床改善率为40.7%。精算肿瘤无进展率3年为100%,5年为91.5%,10年为86%。结论:与显微外科手术相比,GKRS治疗GJTs的长期肿瘤控制率高,神经系统发病率低,因此应被视为一种可靠有效的治疗选择。
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Gamma Knife Radiosurgery as a Dependable, Effective Option for Glomus Jagulare Tumors: A Single Institution Long-Term Experience and Review of the Literature
Objective: Glomus jugulare tumors (GJTs) are benign, slowly growing tumors, highly vascular, with the potential to infiltrate neurovascular structures. Surgical treatment is usually associated with high morbidity and even death. Gamma Knife radiosurgery (GKRS) has been established as an effective treatment option. This retrospective study aims to report and confirm GKRS.'s long-term effectiveness and safety for GJT patients. Methods: A total of 65 patients with GJTs were treated with GKRS, at the authors' center from 2005 to 2020, with a mean follow-up period of 87.7 months. The mean treated GJT volume was 5.4cc with a median prescription dose of 15Gy and a median maximum dose of 42.9Gy. Results: Most patients were females (77%), and the median age at presentation was 48 years. The overall tumor growth control was 93.8% (61 patients) 39% of them achieved tumor size reduction. The overall clinical control was 90.8% (59 patients), and 40.7% achieved clinical improvement. The Actuarial tumor rate free of progression was 100% at 3 years, 91.5% at 5 years, and 86% at 10 years of follow-up. Conclusions: GKRS for GJTs typically results in high long-term tumor control and lower neurological morbidity than those associated with microsurgical resection, therefore should be consider as a dependable effective treatment option.
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