海战伤救治研究中心建设汇报材料-leksellgammaknifesociety

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1、StereotacticRadiosurgeryforChordoma:ClinicalAnalysisof49PatientsSunJunzhao,ZhangJianning,Yuxin,etalHeadgammaknifetreatmentcenter,DepartmentofNeurosurgery,NavyGeneralHospitalofPLA,Beijing,100048,ChinaBackgroundSkullbasechordomasareveryrare,slow-growing,highlyinfiltratingtumorswithhighrecurrencera

2、tes.Althoughhistologicallyconsideredtobealow-gradeneoplasm,chordomasarehighlyrecurrent,makingtheirclinicalprogressionverysimilartothatofmalignanttumors.Theoverallincidenceisapproximately1per1000000.Theyhavebeenreportedinallagegroups,thepeakincidenceisinthefourthdecade.Chordomashaveaslightmale

3、predilection,withamale/femaleratioof1.5:1.BackgroundCompleteresectionisrarelyfeasiblebecausethesetumorstendtoencasecriticalvesselsandcranialnervesoradheretothebrainstem.Surgicalandpostoperativemorbidityandmortalityratesremainhighevenwithcurrentsingleorstagedmicrosurgicalprocedures.Nevertheles

4、s,therecurrentandinvasivenatureoftheselesionswarrantsmultimodalmanagementtoimprovelong-termcontrolratesandoutcomes.BackgroundVariousmodalitiesoffractionatedradiationtherapyhavebeenusedtoincreaselocalcontrolorhaltdiseaseprogression.Stereotacticradiosurgery(SRS)deliversmoreconformalradiationwith

5、greaterradiobiologicaleffectthanconventionalradiationtherapy.Italsoreducestheriskoftoxicitytosurroundingcriticalstructuresandisassociatedwithfewercomplications.InthepresentanalysisweseektodefinetheoutcomesofpatientsharboringachordomawhounderwentSRSasanadjuvanttreatment.ClinicalMaterialandMethod

6、sForty-ninepatientswithaskullbasechordomawereanalyzedretrospectivelywhohadundergoneanopensurgeryfollowedbySRSbetweenApril1998andOctober2012atourdepartment.Therewere26maleand23female.Themedianpatientagewas43.2years(range,17-79years).ClinicalMaterialandMethodsAllpatientswerediagnosedbypatholog

7、y.Fifteenmonths(range,2-60months)afterinitialdiagnosis.EightpatientsunderwentRTpriorSRS.SevenpatientsunderwentSRSpriorRT.ThemediantotaldoseofRTwas56.4Gy(range,45-75Gy).ClinicalsymptomsSymptomNo.ofPatients(%)Diplopia35(71.