頭蓋咽頭腫に対する通常分割高精度放射線外部照射療法の長期成績
術後残存/再発頭蓋咽頭腫に対する通常分割高精度放射線外部照射療法の長期治療成績を遡及的に検討した. 解析対象は29例. 年齢中央値は54歳. 28例で放射線治療直前の手術は不完全切除であった. 三次元原体照射または定位放射線治療を用い, 中央値で54Gy/30分割を残存腫瘍を含む腫瘍床へ投与した. 経過観察期間中央値は73カ月で, 5年の局所制御率, 無増悪生存率, 全生存率は, それぞれ, 85.3%, 81.4%, 95.8%であった. 放射線治療後に甲状腺刺激ホルモン値の低下を認めた1例以外, 放射線治療に起因する有害事象は観察されなかった. 頭蓋咽頭腫に対する通常分割高精度放射線外部照...
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| Published in | 脳神経外科ジャーナル Vol. 25; no. 8; pp. 646 - 653 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本脳神経外科コングレス
2016
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0917-950X 2187-3100 |
| DOI | 10.7887/jcns.25.646 |
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| Abstract | 術後残存/再発頭蓋咽頭腫に対する通常分割高精度放射線外部照射療法の長期治療成績を遡及的に検討した. 解析対象は29例. 年齢中央値は54歳. 28例で放射線治療直前の手術は不完全切除であった. 三次元原体照射または定位放射線治療を用い, 中央値で54Gy/30分割を残存腫瘍を含む腫瘍床へ投与した. 経過観察期間中央値は73カ月で, 5年の局所制御率, 無増悪生存率, 全生存率は, それぞれ, 85.3%, 81.4%, 95.8%であった. 放射線治療後に甲状腺刺激ホルモン値の低下を認めた1例以外, 放射線治療に起因する有害事象は観察されなかった. 頭蓋咽頭腫に対する通常分割高精度放射線外部照射療法の治療成績は良好である. |
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| AbstractList | 術後残存/再発頭蓋咽頭腫に対する通常分割高精度放射線外部照射療法の長期治療成績を遡及的に検討した. 解析対象は29例. 年齢中央値は54歳. 28例で放射線治療直前の手術は不完全切除であった. 三次元原体照射または定位放射線治療を用い, 中央値で54Gy/30分割を残存腫瘍を含む腫瘍床へ投与した. 経過観察期間中央値は73カ月で, 5年の局所制御率, 無増悪生存率, 全生存率は, それぞれ, 85.3%, 81.4%, 95.8%であった. 放射線治療後に甲状腺刺激ホルモン値の低下を認めた1例以外, 放射線治療に起因する有害事象は観察されなかった. 頭蓋咽頭腫に対する通常分割高精度放射線外部照射療法の治療成績は良好である. |
| Author | 小倉, 健吾 坂中, 克行 宇藤, 恵 平岡, 真寛 荒川, 芳輝 溝脇, 尚志 北条, 雅人 宮本, 享 |
| Author_xml | – sequence: 1 fullname: 宇藤, 恵 organization: 京都大学大学院医学研究科放射線腫瘍学・画像応用治療学 – sequence: 1 fullname: 宮本, 享 organization: 京都大学大学院医学研究科脳神経外科学 – sequence: 1 fullname: 平岡, 真寛 organization: 京都大学大学院医学研究科放射線腫瘍学・画像応用治療学 – sequence: 1 fullname: 溝脇, 尚志 organization: 京都大学大学院医学研究科放射線腫瘍学・画像応用治療学 – sequence: 1 fullname: 荒川, 芳輝 organization: 京都大学大学院医学研究科脳神経外科学 – sequence: 1 fullname: 北条, 雅人 organization: 滋賀県立成人病センター脳神経外科 – sequence: 1 fullname: 小倉, 健吾 organization: 京都大学大学院医学研究科放射線腫瘍学・画像応用治療学 – sequence: 1 fullname: 坂中, 克行 organization: 京都大学大学院医学研究科放射線腫瘍学・画像応用治療学 |
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| References | 3) Clark AJ, Cage TA, Aranda D, Parsa AT, Sun PP, Auguste KI, Gupta N : A systematic review of the results of surgery and radiotherapy on tumor control for pediatric craniopharyngioma. Childs Nerv Syst 29 : 231-238, 2013. 21) Russell DS, Rubinstein LJ : Craniopharyngeoma and suprasellar epidermoid cysts. in Eussel DS, Rubinstein LJ (eds) : Pathology of Tumors of the Nervous System, 5th Edtition. London, Edward Arnold, 1989, pp.695-702. 9) Harrabi SB, Adeberg S, Welzel T, Rieken S, Habermehl D, Debus J, Combs SE : Long term results after fractionated stereotactic radiotherapy (FSRT) in patients with craniopharyngioma : maximal tumor control with minimal side effects. Radiat oncol 9 : 203, 2014. 6) Di Pinto M, Conklin HM, Li C, Merchant TE : Learning and memory following conformal radiation therapy for pediatric craniopharyngioma and low-grade glioma. Int J Radiat Oncol Biol Phys 84 : e363-369, 2012. 11) Kalapurakal JA, Goldman S, Hsieh YC, Tomita T, Marymont MH : Clinical outcome in children with recurrent craniopharyngioma after primary surgery. Cancer J 6 : 388-393, 2000. 2) Clark AJ, Cage TA, Aranda D, Parsa AT, Auguste KI, Gupta N : Treatment-related morbidity and the management of pediatric craniopharyngioma : a systematic review. J Neurosurg Pediatr 10 : 293-301, 2012. 13) Merchant TE, Kiehna EN, Sanford RA, Mulhern RK, Thompson SJ, Wilson MW, Lustig RH, Kun LE : Craniopharyngioma : the St. Jude Children’s Research Hospital experience 1984-2001. Int J Radiat Oncol Biol Phys 53 : 533-542, 2002. 4) Combs SE, Thilmann C, Huber PE, Hoess A, Debus J, Schulz-Ertner D : Achievement of long-term local control in patients with craniopharyngiomas using high precision stereotactic radiotherapy. Cancer 109 : 2308-2314, 2007. 14) Merchant TE, Kun LE, Hua CH, Wu S, Xiong X, Sanford RA, Boop FA : Disease control after reduced volume conformal and intensity modulated radiation therapy for childhood craniopharyngioma. Int J Radiat Oncol Biol Phys 85 : e187-192, 2013. 20) Rajan B, Ashley S, Gorman C, Jose CC, Horwich A, Bloom HJ, Marsh H, Brada M : Craniopharyngioma—a long-term results following limited surgery and radiotherapy. Radiother Oncol 26 : 1-10, 1993. 26) Yomo S, Konishi Y, Motohiro H : Long-term treatment results of Gamma Kife stereotactic radiosurgery for craniopharyngeoma. Jpn J Neurosurg 24 : 533-543, 2015. 5) Crowley RK, Hamnvik OP, O’Sullivan EP, Behan LA, Smith D, Agha A, Thompson CJ : Morbidity and mortality in patients with craniopharyngioma after surgery. Clin Endocrinol (Oxf) 73 : 516-521, 2010. 19) Pollock BE, Link MJ, Leavitt JA, Stafford SL : Dose-volume analysis of radiation-induced optic neuropathy after single-fraction stereotactic radiosurgery. Neurosurgery 75 : 456-460 ; discussion 460, 2014. 25) Yang I, Sughrue ME, Rutkowski MJ, Kaur R, Ivan ME, Aranda D, Barani IJ, Parsa AT : Craniopharyngioma : a comparison of tumor control with various treatment strategies. Neurosurg Focus 28 : E5, 2010. 16) Moon SH, Kim IH, Park SW, Kim I, Hong S, Park CI, Wang KC, Cho BK : Early adjuvant radiotherapy toward long-term survival and better quality of life for craniopharyngiomas—a study in single institute. Childs Nerv Syst 21 : 799-807, 2005. 10) Hasegawa T, Kobayashi T, Kida Y : Tolerance of the optic apparatus in single-fraction irradiation using stereotactic radiosurgery : evaluation in 100 patients with craniopharyngioma. Neurosurgery 66 : 688-694 ; disucussion 694-685, 2010. 18) Niranjan A, Kano H, Mathieu D, Kondziolka D, Flickinger JC, Lunsford LD : Radiosurgery for craniopharyngioma. Int J Radiat Oncol Biol Phys 78 : 71, 2010. 1) Caldarelli M, Massimi L, Tamburrini G, Cappa M, Di Rocco C : Long-term results of the surgical treatment of craniopharyngioma : the experience at the Policlinico Gemelli, Catholic University, Rome. Childs Nerv Syst 21 : 747-757, 2005. 24) Winkfield KM, Bazan JG, Gibbs IC, Eng TY, C. R. T : Craniopharingeoma in Nonmalignant diseases (Chapter 91). in Halperin EC, Wazer DE, Perez CA, Brady LW (eds) : Perez and Brady’s Principles and Practice of Radiation Oncology, Sixth Edition. Philadelphia, Lippencott Williams & Wilkins, 2011, pp.1733-1736. 12) Lo AC, Howard AF, Nichol A, Sidhu K, Abdulsatar F, Hasan H, Goddard K : Long-term outcomes and complications in patients with craniopharyngioma : the British Columbia Cancer Agency experience. Int J Radiat Oncol Biol Phys 88 : 1011-1018, 2014. 22) Shrieve D, Wagner AE : Craniopharyngioma. in Gaffney DK, Shrieve D, Anker CJ, Buyyounouski MK, Kong FM, Hitchcock YJ, Tward JD (eds) : Radiation Oncology Imaging and Treatment. Altona, Amirsys Publishing, 2013, pp.22-23. 7) Emami B, Lyman J, Brown A, Coia L, Goitein M, Munzenrider JE, Shank B, Solin LJ, Wesson M : Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 21 : 109-122, 1991. 17) Mortini P, Losa M, Pozzobon G, Barzaghi R, Riva M, Acerno S, Angius D, Weber G, Chiumello G, Giovanelli M : Neurosurgical treatment of craniopharyngioma in adults and children : early and long-term results in a large case series. J Neurosurg 114 : 1350-1359, 2011. 23) Sughrue ME, Yang I, Kane AJ, Fang S, Clark AJ, Aranda D, Barani IJ, Parsa AT : Endocrinologic, neurologic, and visual morbidity after treatment for craniopharyngioma. J Neurooncol 101 : 463-476, 2011. 15) Minniti G, Saran F, Traish D, Soomal R, Sardell S, Gonsalves A, Ashley S, Warrington J, Burke K, Mosleh-Shirazi A, Brada M : Fractionated stereotactic conformal radiotherapy following conservative surgery in the control of craniopharyngiomas. Radiother Oncol 82 : 90-95, 2007. 8) Habrand JL, Ganry O, Couanet D, Rouxel V, Levy-Piedbois C, Pierre-Kahn A, Kalifa C : The role of radiation therapy in the management of craniopharyngioma : a 25-year experience and review of the literature. Int J Radiat Oncol Biol Phys 44 : 255-263, 1999. |
| References_xml | – reference: 5) Crowley RK, Hamnvik OP, O’Sullivan EP, Behan LA, Smith D, Agha A, Thompson CJ : Morbidity and mortality in patients with craniopharyngioma after surgery. Clin Endocrinol (Oxf) 73 : 516-521, 2010. – reference: 15) Minniti G, Saran F, Traish D, Soomal R, Sardell S, Gonsalves A, Ashley S, Warrington J, Burke K, Mosleh-Shirazi A, Brada M : Fractionated stereotactic conformal radiotherapy following conservative surgery in the control of craniopharyngiomas. Radiother Oncol 82 : 90-95, 2007. – reference: 18) Niranjan A, Kano H, Mathieu D, Kondziolka D, Flickinger JC, Lunsford LD : Radiosurgery for craniopharyngioma. Int J Radiat Oncol Biol Phys 78 : 71, 2010. – reference: 17) Mortini P, Losa M, Pozzobon G, Barzaghi R, Riva M, Acerno S, Angius D, Weber G, Chiumello G, Giovanelli M : Neurosurgical treatment of craniopharyngioma in adults and children : early and long-term results in a large case series. J Neurosurg 114 : 1350-1359, 2011. – reference: 9) Harrabi SB, Adeberg S, Welzel T, Rieken S, Habermehl D, Debus J, Combs SE : Long term results after fractionated stereotactic radiotherapy (FSRT) in patients with craniopharyngioma : maximal tumor control with minimal side effects. Radiat oncol 9 : 203, 2014. – reference: 24) Winkfield KM, Bazan JG, Gibbs IC, Eng TY, C. R. T : Craniopharingeoma in Nonmalignant diseases (Chapter 91). in Halperin EC, Wazer DE, Perez CA, Brady LW (eds) : Perez and Brady’s Principles and Practice of Radiation Oncology, Sixth Edition. Philadelphia, Lippencott Williams & Wilkins, 2011, pp.1733-1736. – reference: 7) Emami B, Lyman J, Brown A, Coia L, Goitein M, Munzenrider JE, Shank B, Solin LJ, Wesson M : Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 21 : 109-122, 1991. – reference: 13) Merchant TE, Kiehna EN, Sanford RA, Mulhern RK, Thompson SJ, Wilson MW, Lustig RH, Kun LE : Craniopharyngioma : the St. Jude Children’s Research Hospital experience 1984-2001. Int J Radiat Oncol Biol Phys 53 : 533-542, 2002. – reference: 6) Di Pinto M, Conklin HM, Li C, Merchant TE : Learning and memory following conformal radiation therapy for pediatric craniopharyngioma and low-grade glioma. Int J Radiat Oncol Biol Phys 84 : e363-369, 2012. – reference: 19) Pollock BE, Link MJ, Leavitt JA, Stafford SL : Dose-volume analysis of radiation-induced optic neuropathy after single-fraction stereotactic radiosurgery. Neurosurgery 75 : 456-460 ; discussion 460, 2014. – reference: 4) Combs SE, Thilmann C, Huber PE, Hoess A, Debus J, Schulz-Ertner D : Achievement of long-term local control in patients with craniopharyngiomas using high precision stereotactic radiotherapy. Cancer 109 : 2308-2314, 2007. – reference: 8) Habrand JL, Ganry O, Couanet D, Rouxel V, Levy-Piedbois C, Pierre-Kahn A, Kalifa C : The role of radiation therapy in the management of craniopharyngioma : a 25-year experience and review of the literature. Int J Radiat Oncol Biol Phys 44 : 255-263, 1999. – reference: 1) Caldarelli M, Massimi L, Tamburrini G, Cappa M, Di Rocco C : Long-term results of the surgical treatment of craniopharyngioma : the experience at the Policlinico Gemelli, Catholic University, Rome. Childs Nerv Syst 21 : 747-757, 2005. – reference: 3) Clark AJ, Cage TA, Aranda D, Parsa AT, Sun PP, Auguste KI, Gupta N : A systematic review of the results of surgery and radiotherapy on tumor control for pediatric craniopharyngioma. Childs Nerv Syst 29 : 231-238, 2013. – reference: 25) Yang I, Sughrue ME, Rutkowski MJ, Kaur R, Ivan ME, Aranda D, Barani IJ, Parsa AT : Craniopharyngioma : a comparison of tumor control with various treatment strategies. Neurosurg Focus 28 : E5, 2010. – reference: 2) Clark AJ, Cage TA, Aranda D, Parsa AT, Auguste KI, Gupta N : Treatment-related morbidity and the management of pediatric craniopharyngioma : a systematic review. J Neurosurg Pediatr 10 : 293-301, 2012. – reference: 11) Kalapurakal JA, Goldman S, Hsieh YC, Tomita T, Marymont MH : Clinical outcome in children with recurrent craniopharyngioma after primary surgery. Cancer J 6 : 388-393, 2000. – reference: 10) Hasegawa T, Kobayashi T, Kida Y : Tolerance of the optic apparatus in single-fraction irradiation using stereotactic radiosurgery : evaluation in 100 patients with craniopharyngioma. Neurosurgery 66 : 688-694 ; disucussion 694-685, 2010. – reference: 16) Moon SH, Kim IH, Park SW, Kim I, Hong S, Park CI, Wang KC, Cho BK : Early adjuvant radiotherapy toward long-term survival and better quality of life for craniopharyngiomas—a study in single institute. Childs Nerv Syst 21 : 799-807, 2005. – reference: 26) Yomo S, Konishi Y, Motohiro H : Long-term treatment results of Gamma Kife stereotactic radiosurgery for craniopharyngeoma. Jpn J Neurosurg 24 : 533-543, 2015. – reference: 12) Lo AC, Howard AF, Nichol A, Sidhu K, Abdulsatar F, Hasan H, Goddard K : Long-term outcomes and complications in patients with craniopharyngioma : the British Columbia Cancer Agency experience. Int J Radiat Oncol Biol Phys 88 : 1011-1018, 2014. – reference: 14) Merchant TE, Kun LE, Hua CH, Wu S, Xiong X, Sanford RA, Boop FA : Disease control after reduced volume conformal and intensity modulated radiation therapy for childhood craniopharyngioma. Int J Radiat Oncol Biol Phys 85 : e187-192, 2013. – reference: 20) Rajan B, Ashley S, Gorman C, Jose CC, Horwich A, Bloom HJ, Marsh H, Brada M : Craniopharyngioma—a long-term results following limited surgery and radiotherapy. Radiother Oncol 26 : 1-10, 1993. – reference: 21) Russell DS, Rubinstein LJ : Craniopharyngeoma and suprasellar epidermoid cysts. in Eussel DS, Rubinstein LJ (eds) : Pathology of Tumors of the Nervous System, 5th Edtition. London, Edward Arnold, 1989, pp.695-702. – reference: 22) Shrieve D, Wagner AE : Craniopharyngioma. in Gaffney DK, Shrieve D, Anker CJ, Buyyounouski MK, Kong FM, Hitchcock YJ, Tward JD (eds) : Radiation Oncology Imaging and Treatment. Altona, Amirsys Publishing, 2013, pp.22-23. – reference: 23) Sughrue ME, Yang I, Kane AJ, Fang S, Clark AJ, Aranda D, Barani IJ, Parsa AT : Endocrinologic, neurologic, and visual morbidity after treatment for craniopharyngioma. J Neurooncol 101 : 463-476, 2011. |
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| Snippet | 術後残存/再発頭蓋咽頭腫に対する通常分割高精度放射線外部照射療法の長期治療成績を遡及的に検討した. 解析対象は29例. 年齢中央値は54歳. 28例で放射線治療直前の手術は不完全切除であった. 三次元原体照射または定位放射線治療を用い, 中央値で54Gy/30分割を残存腫瘍を含む腫瘍床へ投与した.... |
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| SubjectTerms | conventional fractionation craniopharyngioma high-precision external-beam radiation therapy stereotactic radiation therapy |
| Title | 頭蓋咽頭腫に対する通常分割高精度放射線外部照射療法の長期成績 |
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