术后残留中枢神经细胞瘤的放射治疗(附六例报告)

目的 探讨放射治疗在术后残留或复发中枢神经细胞瘤中的作用.方法 分析2003年6月至2005年6月收治的6例手术后残留或复发的中枢神经细胞瘤的放射治疗结果 ,并综述文献报道.结果 5例病人接受外放射治疗,放射剂量55～60 Gy,随访24-36个月(平均30个月),病变消失1例,缩小4例.其中1例于放射治疗结束后6个月时出现一侧丘脑放射性坏死.1例病人行伽玛刀治疗,周边剂量15 Gy,随访至18个月时病变已明显缩小.结论 中枢性神经细胞瘤确对放射治疗敏感,对术后残留或复发者可以考虑分次外放射治疗,54 Gy可能是治疗中枢神经细胞瘤的最低有效剂量,但应注意放射性副损伤或放射性坏死发生的可能,对小体积肿瘤,立体定向放射外科治疗则是一种安全有效的辅助治疗.

Radiation therapy for residual neurocytoma

Objective To investigate the role of radiation therapy in the treatment of postoperative residual or recurrent central neurocytoma. Methods The outcome of radiation therapy for 6 patients with residual neurocytom was analyzed and the related literatures were reviewed. Results In five patients treated by radiotherapy, with the dose ranged from 55 to 60 Gy and the follow-up period from 24 to 36 months, the tumor disappearance was found in 1 patient and reduction in tumor size in 4 cases. One patient experienced delayed radiative-necrosis in the parenchyma of thalamus adjacent to the tumor covered by the field of radiation therapy. One patient was treated by Gamma Knife surgery with the prescribed dose of 15 Gy. Eighteen months later, the tumor had decreased in size and the patient remained neurologically intact. Conclusion It is suggested that the central neurocytoma is sensitive to radiation and the radiation therapy appears to have an effect on tumor control. A radiation dose of 54 Gy appeared sufficient. However, it should be carefully decided whether to use radiation therapy for a residual tumor, taking into account the benign biologic behavior and potential radiation toxicity. Gamma knife surgery may be an effective and safe treatment choice for patient.