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首页> 外文期刊>British journal of neurosurgery >Linear accelerator radiosurgery for vestibular schwannomas: Results of medium-term follow-up
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Linear accelerator radiosurgery for vestibular schwannomas: Results of medium-term follow-up

机译：线性加速器放射外科治疗前庭神经鞘瘤：中期随访结果

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Background. To examine tumour control, via volume changes, and the complications of linear accelerator (LINAC)-based stereotactic radiosurgery (SRS) treatment of vestibular schwannomas (VSs) on medium-term follow-up. Methods. Between September 2003 and November 2009 fifty consecutive patients with VSs treated with SRS using a marginal dose of 12.5 Gy utilizing a LINAC equipped with a micro-multileaf collimator were identified. Evaluation included serial magnetic resonance imaging (MRI), and neurological and hearing examinations. Results. The median tumour volume at treatment was 2.4 (range: 0.24-10.59) cm(3). The intracranial diameter of the tumours ranged between 7.7 and 28.7 (median: 15.8) mm. Follow-up MRI was available for analysis on 49 patients. The median radiological follow-up period was 5.8 (range: 1.4-9.2) years. The median tumour volume at last follow-up was 1.1 (range: 0.03-5.3) cm(3). VS decreased in size in 45 (90%) patients, with a median reduction in tumour volume of 1.46 (range: 0.06-9.29) cm(3) or a median tumour size reduction of 59% of the baseline (range: 6-90%) in these patients. VS remained stable in 2 patients and increased in size in 2 patients. Only 1 patient (2%) required additional intervention (surgery). 15 patients had useful hearing pre-treatment; 10 post-treatment pure-tone audiograms of these patients were available. 5 (50%) patients still had useful hearing post treatment. Non-auditory adverse radiation effects included new (House-Brackmann grade II) or worsened facial nerve palsy (House-Brackmann grade II to grade V) in 2 (4%) patients and trigeminal sensory disturbance in 2 (4%) patients. Conclusions. At medium term, the vast majority of VSs treated with LINAC-based SRS exhibit tumour shrinkage. The slightly higher rate of facial nerve palsy compared with Gamma Knife surgery (GKS) results may be related to the learning curve. Other complications were similar to reported GKS results for VSs of comparable sizes.
机译：背景。若要检查肿瘤的控制，通过体积变化和中期随访基于线性加速器（LINAC）的立体定向放射外科（SRS）治疗前庭神经鞘瘤（VSs）的并发症。方法。在2003年9月至2009年11月之间，确定了连续50例VS患者，他们使用LINAC配备微多叶准直仪，以12.5 Gy的边缘剂量用SRS治疗。评估包括串行磁共振成像（MRI）以及神经和听力检查。结果。治疗时的中位肿瘤体积为2.4（范围：0.24-10.59）cm（3）。肿瘤的颅内直径在7.7和28.7（中位数：15.8）毫米之间。随访MRI可分析49例患者。中位放射学随访期为5.8年（范围：1.4-9.2）。最近一次随访的中位肿瘤体积为1.1（范围：0.03-5.3）cm（3）。 VS在45例（90％）患者中缩小，肿瘤体积中位数减少1.46毫米（范围：0.06-9.29）cm（3）或中位数肿瘤大小缩小基线的59％（范围：6-90毫米） ％）在这些患者中。 VS在2例患者中保持稳定，在2例中体积增大。只有1名患者（2％）需要额外的干预（手术）。 15名患者接受了有用的听力治疗;这些患者有10个治疗后的纯音听力图。 5名（50％）患者在治疗后仍具有有用的听力。非听觉不良辐射影响包括2例（4％）患者出现新的（House-Brackmann II级）或恶化的面神经麻痹（House-Brackmann II级至V级）以及2例（4％）患者的三叉神经感觉障碍。结论在中期，绝大多数用基于LINAC的SRS治疗的VS表现出肿瘤缩小。与伽玛刀手术（GKS）相比，面神经麻痹的发生率略高，可能与学习曲线有关。其他并发症与报道的可比较大小的VS的GKS结果相似。

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