低分割放疗治疗颈部血管瘤的疗效观察
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摘要
目的:分析低分割放射治疗对颈部血管瘤的疗效。方法:回顾性分析我院7例颈部血管瘤患者,其中颈动脉体瘤患者2例,颈静脉球瘤患者5例,采用低分割放射治疗,肿瘤剂量DT 55 Gy(BED:82.5 Gy)/11 f,随访26～48个月。结果:采用低分割三维适形放疗后患者瘤体缩小明显,放疗前后肿瘤大小比较差异有统计学意义(P<0.05);其中缓解明显6例,随访期间未复发,总有效率85.7%;放疗前后患者生活质量评分比较差异有统计学意义(P<0.05)。结论:放射治疗是无法手术或不愿手术颈部血管瘤患者的首选治疗方法,低分割放疗可使肿瘤明显缩小,缩短治疗时间,迅速改善患者临床症状,提高生活质量,肿瘤复发率低,长期疗效显著。
Objective:To observe the clinical effect of hypofractionated radiotherapy to carotid body tumor and glomus jugulare tumor.Methods:There were 7 patients with cervical hemangioma,in which 2 patients were tumor of carotid body and 5 patients were tumor of glomus jugulare.All of them adopted hypofractionated radiotherapy,dose of radiotherapy for tumor 55 Gy(BED:82.5)/11 faction,follow-up 26～48 months.Results:There was significant difference to compare the size of tumor before and after radiotherapy(P<0.05),6 cases had obvious effect,no recurrence during the follow-up period.The effective rate was 85.7%.There was significant difference to compare the quality of life before and after radiotherapy(P<0.05).Conclusion:Radiotherapy is perferred treatment with cervical hemangioma patients who are unwilingness or inability to operate.Hypofractionated radiotherapy makes the tumor significantly reduced,improves clinical symptoms,and the quality of life.Long-term curative effect is remarkable.
Objective:To observe the clinical effect of hypofractionated radiotherapy to carotid body tumor and glomus jugulare tumor.Methods:There were 7 patients with cervical hemangioma,in which 2 patients were tumor of carotid body and 5 patients were tumor of glomus jugulare.All of them adopted hypofractionated radiotherapy,dose of radiotherapy for tumor 55 Gy(BED:82.5)/11 faction,follow-up 26～48 months.Results:There was significant difference to compare the size of tumor before and after radiotherapy(P<0.05),6 cases had obvious effect,no recurrence during the follow-up period.The effective rate was 85.7%.There was significant difference to compare the quality of life before and after radiotherapy(P<0.05).Conclusion:Radiotherapy is perferred treatment with cervical hemangioma patients who are unwilingness or inability to operate.Hypofractionated radiotherapy makes the tumor significantly reduced,improves clinical symptoms,and the quality of life.Long-term curative effect is remarkable.
引文
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[12] Tian CQ,Geng HS,Cui LC.3 casea report of 3 dimensional radiation therapy for glomus jugulare tumors[J].Modern Oncology,2013,21(11):2434-2436.[田春琴,耿会生,崔立春.颈静脉球瘤的三维立体适形放疗3 例报告[J].现代肿瘤医学,2013,21(11):2434-2436.]
[13] Hafez RFA,Morgan MS,Fahmy OM,et al.Long-term effectiveness and safety of stereotactic gamma knife surgery as a primary sole treatment in the management of glomus jagulare tumor[J].Clin Neurol Neurosurg,2018,168:34-37.
[14] Wakefield DV,Venable GT,Vander Walde NA,et al.Comparative neurologic outcomes of salvage and definitive gamma knife radiosurgery for glomus jugulare:A 20-year experience [J].J Neurol Surg B Skull Base,2017,78(3):251-255.
[15] Jacob JT,Pollock BE,Carlson ML,et al.Stereotacic radiosurgery in the mamagement of vestibular schwannom and glomus jugulare:indications,techniques,and results[J].Otolaryngologic Clinics of North America,2015,48(3):515-526.
[2] Roberton JH,Brodleey JA.Glomus jugulare tumors[J].Neurological Sugery,1996,14(4):3089-3091.
[3] Boyle JO,Shimm DS,Coulthard SW.Radiation therapy for paragangliomas of the temporal bone[J].Laryngo-scope,1990,100(8):896-901.
[4] kakkos SK,Zampakis P,Lampropoulos GC,et al.Successful resection of a large carotid body tumor masquerading complete encasement of the internal carotid artery on preoperative imaging [J].Vasc Endovascular Surg,2018,52(4):304-308.
[5] Huang DL,Yang WY,Zhou DB,et al.The diagnosis and treatment with glomus jugulare tumor [J].The Journal of Chinese Medical,2002,82(20):1381-1384.[黄德亮,杨伟炎,周定标,等.颈静脉球瘤的诊断与治疗[J].中华医学杂志,2002,82(20):1381-1384.]
[6] Tang W.1 case with glomus jugulare tumor and paraganglioma literature review[J].The Chinese Journal of Clinical and Experimental Psthology,2006,22(2):211-213.[唐威.颈静脉球瘤1例及副神经节瘤文献复习[J].临床与实验病理学杂志,2006,22(2):211-213.]
[7] Kaygusuz I,Karlidag T.Carotid body tumor:Clinical features[J].The Journal of Craniofacical Surgery,2015,26(7):586-589.
[8] Manjaly JG,Alexander VR,Pepper CM,et al.Primary cervical ganglioneuro blastoma[J].Int J Pediatr Otorhinolaryngol,2015,79:1007-1012.
[9] He ZM.The analysis of 23 cases with carotid body tumor[J].Journal of Chinese and Foreign Medical Research,2014,12(20):140-141.[何敏志.颈动脉体瘤23例诊治分析[J].中外医学研究,2014,12(20):140-141.]
[10] Pacheco-Ojeda LA.Carotid body tumors:Surgical experience in 215 cases[J].J Craniomaxillofac Surg,2017,45(9):1472-1477.
[11] Mayur Sharma,Antonio Meola,Sushma Bellamkonda,et al.Long-term outcome following stereotactic radiosurgery for glomus jugulare tumors:A single institution experience of 20 years[J].NEUR Surg,2017,11(4):104-110.
[12] Tian CQ,Geng HS,Cui LC.3 casea report of 3 dimensional radiation therapy for glomus jugulare tumors[J].Modern Oncology,2013,21(11):2434-2436.[田春琴,耿会生,崔立春.颈静脉球瘤的三维立体适形放疗3 例报告[J].现代肿瘤医学,2013,21(11):2434-2436.]
[13] Hafez RFA,Morgan MS,Fahmy OM,et al.Long-term effectiveness and safety of stereotactic gamma knife surgery as a primary sole treatment in the management of glomus jagulare tumor[J].Clin Neurol Neurosurg,2018,168:34-37.
[14] Wakefield DV,Venable GT,Vander Walde NA,et al.Comparative neurologic outcomes of salvage and definitive gamma knife radiosurgery for glomus jugulare:A 20-year experience [J].J Neurol Surg B Skull Base,2017,78(3):251-255.
[15] Jacob JT,Pollock BE,Carlson ML,et al.Stereotacic radiosurgery in the mamagement of vestibular schwannom and glomus jugulare:indications,techniques,and results[J].Otolaryngologic Clinics of North America,2015,48(3):515-526.