METHODS: This study was conducted on 128 patients with CSM treated with LINAC-based SRS/FSR between 2005 and 2020 at a single institution. 46 patients presented with CNNs. The study analyzed patients\' demographics, clinical parameters, SRS/FSR treatment characteristics, post-treatment CNNs recovery duration, status, and radiological control on their last follow-up.
RESULTS: The median follow-up duration was 53.4 months. Patients were treated with SRS (n = 25) or FSR (n = 21). The mean pretreatment tumor volume was 9.5 cc decreasing to a mean end-of-follow-up tumor volume was 5.1 cc. Radiological tumor control was achieved in all cases. CNN recovery was observed in 80.4% of patients, with specific nerve recoveries documented as follows: extra-ocular nerves (43.2%), trigeminal nerve (32.4%), and optic nerve (10.8%). A higher CNNs recovery rate was associated with a smaller pre-treatment tumor volume (p < 0.001), and the median time-to-improvement was 3.7 months. Patients with tumor volumes exceeding 6.8 cc and those treated with FSR exhibited prolonged time-to-improvement (P < 0.03 and P < 0.04 respectively).
CONCLUSIONS: This study suggests that SRS/FSR for CSM provides good and sustainable CNNs recovery outcomes with excellent long-term radiological control. A higher CNNs recovery rate was associated with a smaller pre-treatment tumor volume. while shorter time-to-improvement was identified in patients treated with SRS compared to FSR, particularly in those with small pre-treatment tumor volume.
方法:这项研究是在2005年至2020年间在单一机构接受基于LINAC的SRS/FSR治疗的128例CSM患者中进行的。46名患者出现CNN。这项研究分析了患者的人口统计学,临床参数,SRS/FSR处理特性,后处理CNN恢复持续时间,status,和他们最后一次随访的放射控制。
结果:中位随访时间为53.4个月。患者接受SRS(n=25)或FSR(n=21)治疗。平均治疗前肿瘤体积为9.5cc,减少至平均随访结束时肿瘤体积为5.1cc。在所有情况下都实现了放射学肿瘤控制。在80.4%的患者中观察到CNN恢复,具体的神经恢复记录如下:眼外神经(43.2%),三叉神经(32.4%),和视神经(10.8%)。较高的CNNs恢复率与较小的治疗前肿瘤体积相关(p<0.001),中位改善时间为3.7个月.肿瘤体积超过6.8cc的患者和接受FSR治疗的患者表现出延长的改善时间(分别为P<0.03和P<0.04)。
结论:这项研究表明,CSM的SRS/FSR可提供良好且可持续的CNN恢复结果,并具有出色的长期放射学控制。较高的CNNs恢复率与较小的治疗前肿瘤体积相关。与FSR相比,SRS治疗的患者的改善时间更短,特别是那些治疗前肿瘤体积较小的患者。