PDF(Pubmed)
Abstract：
Background Although international publications on radiosurgery have increased exponentially, reports of heterogeneous series treated with linear accelerator (LINAC) are scarce. Since most intracranial tumors are irregular in size and not spherical, LINACs (Elekta Precise®, Elekta AB, Sweden), fitted with a multi-leaf collimator, allow for precise stereotactic radiosurgery for the entire tumor. Aim To evaluate the effects of LINAC on an outpatient basis with patients diagnosed with various intracranial malignancies. Methodology A retrospective observational study of a series of cases of patients with intracranial lesions treated at the Institute of Oncology and Radiobiology using LINAC was carried out from October 2019 to May 2021 to evaluate the therapeutic results of radiosurgery in patients with intracranial tumors. Results A total of 22 lesions in 20 patients were treated with LINAC. The average age of the patients was 49.7, and the male-female ratio was 1:2. The cases consisted were mostly vestibular schwannoma (7 lesions), metastases from breast cancer (3 lesions), and tuberculum sellae meningioma (2 lesions). The prescription dose covered 99% of the planning target volume in 16 lesions (72.7%) and 100% in six lesions (27.3%) (prescription volume). In meningiomas and schwannomas, doses between 12 and 14 Gy were used, in plasmacytoma 13 Gy, in pilocytic astrocytoma 14 Gy, in cavernoma 15 Gy, in breast cancer metastasis between 18 and 20 Gy, and in lung cancer metastasis 22 Gy. When evaluating local control, 11 patients exhibited stable findings at the six-month control while 10 had partial regression, and a single patient had total regression. Minor complications such as perilesional edema, facial paresthesia, facial paralysis, and transient alopecia were observed in eight of the patients. Conclusions Patients with extra-axial, low-grade malignancy, and posterior fossa lesions were predominant in the studied population. Radiosurgery treatment is associated with good local control of the treated lesions. Complications are infrequent, mild, and predominated by perilesional edema.
摘要：
背景技术尽管关于放射外科的国际出版物呈指数级增长,用线性加速器(LINAC)处理的异质系列的报告很少。由于大多数颅内肿瘤大小不规则，而不是球形，LINAC(ElektaPrecise®,ElektaAB,瑞典),装有多叶准直器，允许对整个肿瘤进行精确的立体定向放射外科治疗。目的评估LINAC在门诊对诊断为各种颅内恶性肿瘤的患者的影响。方法对2019年10月至2021年5月在肿瘤和放射生物学研究所使用LINAC治疗的一系列颅内病变患者进行回顾性观察性研究，以评估颅内肿瘤患者的放射外科治疗效果。结果20例患者共22个病灶行LINAC治疗。患者的平均年龄为49.7，男女比例为1：2。这些病例主要是前庭神经鞘瘤（7个病变），乳腺癌转移（3个病灶），和鞍结节脑膜瘤（2个病灶）。处方剂量覆盖了16个病变（72.7％）和6个病变（27.3％）（处方量）的计划目标体积的99％。在脑膜瘤和神经鞘瘤中，使用12至14Gy的剂量，在13Gy浆细胞瘤中，在毛细胞星形细胞瘤14Gy，在15Gy海绵状瘤中，在18至20Gy之间的乳腺癌转移中，而在肺癌转移中22Gy。评估本地控制时，11例患者在六个月的控制下表现出稳定的发现，而10例患者部分消退，1例患者总体消退。轻微的并发症，如病灶周围水肿，面部感觉异常,面瘫,8例患者出现短暂性脱发。结论轴外患者,低度恶性肿瘤,在研究人群中，后颅窝病变占优势。放射外科治疗与治疗病变的良好局部控制相关。并发症很少见，温和,以病灶周围水肿为主。
