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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >High precision conformal radiotherapy employing conservative margins in childhood benign and low-grade brain tumours.
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High precision conformal radiotherapy employing conservative margins in childhood benign and low-grade brain tumours.

机译：高精度保形放射疗法在儿童良性和低度脑肿瘤中采用保守的余量。

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BACKGROUND AND PURPOSE: To report local control and follow up outcome data of high precision conformal radiotherapy in childhood brain tumours. MATERIALS AND METHODS: Between December 1999 and December 2002, 26 children (17 boys and 9 girls, median age 11.5 years) with incompletely excised or recurrent benign and low-grade brain tumours [13 craniopharyngiomas, 11 low-grade gliomas (LGG) and 2 others] were treated with three-dimensional (3D) conformal radiotherapy (CRT) (12 patients) and stereotactic conformal radiotherapy (SCRT) (14 patients). Gross tumour volume (GTV) included neuro-imaging based visible tumour and/or resected tumour bed. Clinical target volume (CTV) consisted of GTV+ 5mm margin and planning target volume (PTV) consisted of additional 5mm margin for CRT and 2mm for SCRT. Treatment was delivered with 3-9 conformal fixed fields to a median dose of 54Gy/30 fractions. RESULTS: The actuarial 2 and 3 year disease free and overall survival was 96 and 100%, respectively (median follow up: 25 months, range 12-47 months). Radiological follow up available in 25 patients revealed complete response in 1, partial regression in 10, stable disease in 13 and progression in 1 patient (within the CTV). One patient with craniopharyngioma on a routine imaging revealed a mild asymptomatic cyst enlargement, which resolved with conservative management. A patient with chiasmatic glioma developed cystic degeneration and hydrocephalus 9 months after SCRT requiring cyst drainage and placement of a ventriculoperitoneal shunt. CONCLUSION: High-precision conformal techniques delivering irradiation to a computer generated target volume employing 7-10mm 3D margins beyond the visible tumour and/or resected tumour bed appear to be safe in children with incompletely resected or recurrent benign and low-grade brain tumours, based on these data.
机译：背景与目的：报道儿童脑肿瘤中高精度保形放射治疗的局部控制和随访结果数据。材料与方法：在1999年12月至2002年12月之间，有26例儿童（17例男孩和9例女孩，中位年龄11.5岁）患有不完全切除或复发的良性和低度脑肿瘤[13例颅咽管瘤，11例低度神经胶质瘤（LGG）和另外2人]分别接受了三维（3D）保形放射治疗（CRT）（12例）和立体定向保形放射治疗（SCRT）（14例）。总肿瘤体积（GTV）包括基于神经影像的可见肿瘤和/或切除的肿瘤床。临床目标体积（CTV）由GTV + 5mm边缘组成，而计划目标体积（PTV）由CRT的另外5mm边缘和SCRT的2mm组成。用3-9个保形固定区域进行治疗，中位剂量为54Gy / 30分数。结果：2年和3年无精算病和总生存率分别为96％和100％（中位随访时间：25个月，范围12-47个月）。 25例患者的放射学随访结果显示完全缓解1例，部分消退10例，疾病稳定13例，进展1例（在CTV内）。例行常规影像学检查的颅咽管瘤患者表现为轻度无症状的囊肿增大，可通过保守治疗解决。一名患有阵发性神经胶质瘤的患者在SCRT术后9个月出现了囊性变性和脑积水，需要进行囊肿引流并放置脑室-腹膜分流器。结论：对于未完全切除或复发的良性和低度脑肿瘤的儿童，高精度的保形技术可将辐射照射到计算机生成的目标体积上，并在可见肿瘤和/或切除的肿瘤床旁使用7-10mm 3D边缘，这似乎是安全的，基于这些数据。

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