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,highlyinfiltratingtumorswithhighrecurrencer

2、ates.Althoughhistologicallyconsideredtobealow-gradeneoplasm,chordomasarehighlyrecurrent,makingtheirclinicalprogressionverysimilartothatofmalignanttumors.Theoverallincidenceisapproximately1per1000000.Theyhavebeenreportedinallagegroups,thepeakincidenceisinthefourthdecade.Chordomashaveaslightma

3、lepredilection,withamale/femaleratioof1.5:1.BackgroundCompleteresectionisrarelyfeasiblebecausethesetumorstendtoencasecriticalvesselsandcranialnervesoradheretothebrainstem.Surgicalandpostoperativemorbidityandmortalityratesremainhighevenwithcurrentsingleorstagedmicrosurgicalprocedures.Neverthe

4、less,therecurrentandinvasivenatureoftheselesionswarrantsmultimodalmanagementtoimprovelong-termcontrolratesandoutcomes.BackgroundVariousmodalitiesoffractionatedradiationtherapyhavebeenusedtoincreaselocalcontrolorhaltdiseaseprogression.Stereotacticradiosurgery(SRS)deliversmoreconformalradiation

5、withgreaterradiobiologicaleffectthanconventionalradiationtherapy.Italsoreducestheriskoftoxicitytosurroundingcriticalstructuresandisassociatedwithfewercomplications.InthepresentanalysisweseektodefinetheoutcomesofpatientsharboringachordomawhounderwentSRSasanadjuvanttreatment.ClinicalMaterialandM

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

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