文章：

颅底脊索瘤与软骨肉瘤患者接受粒子放疗后颞叶反应与放射性坏死的模式分析——单中心经验

Patterns of Temporal Lobe Reaction and Radiation Necrosis after Particle Radiotherapy in Patients with Skull Base Chordoma and Chondrosarcoma—A Single-Center Experience

原文发布日期：8 February 2024

DOI: 10.3390/cancers16040718

类型: Article

开放获取: 是

英文摘要：

Background: The current study aims to evaluate the occurrence of temporal lobe reactions and identify possible risk factors for patients who underwent particle therapy of the skull base. Methods: 244 patients treated for skull base chordoma (n= 144) or chondrosarcoma (n= 100) at the Heidelberg Ion Beam Therapy Center (HIT) using a raster scan technique, were analyzed. Follow-up MRI-scans were matched with the initial planning images. Radiogenic reactions were contoured and analyzed based on volume and dose of treatment. Results: 51 patients with chordoma (35.4%) and 30 patients (30%) with chondrosarcoma experienced at least one temporal lobe reaction within the follow-up period (median 49 months for chondrosarcoma, 62 months for chordoma). Age, irradiated volume, and dose values were significant risk factors for the development of temporal lobe reactions with the highest significance for the value of DMax-7 being defined as the dose maximum in the temporal lobe minus the 7cc with the highest dose (p= 0.000000000019; OR 1.087). Conclusion: Temporal lobe reactions are a common side effect after particle therapy of the skull base. We were able to develop a multivariate model, which predicted radiation reactions with a specificity of 99% and a sensitivity of 52.2%.

摘要翻译： 

背景：本研究旨在评估接受颅底粒子治疗患者颞叶反应的发生情况，并识别其潜在风险因素。方法：对海德堡离子束治疗中心采用光栅扫描技术治疗的244例颅底脊索瘤（n=144）或软骨肉瘤（n=100）患者进行分析。将随访MRI图像与初始计划图像进行匹配，根据治疗体积和剂量对放射性反应进行勾画分析。结果：随访期间（软骨肉瘤中位随访49个月，脊索瘤62个月），51例脊索瘤患者（35.4%）和30例软骨肉瘤患者（30%）出现至少一次颞叶反应。年龄、照射体积和剂量值是颞叶反应发生的显著风险因素，其中以DMax-7值（定义为颞叶最大剂量减去最高剂量7cc体积的剂量值）最具统计学意义（p=0.000000000019；OR 1.087）。结论：颞叶反应是颅底粒子治疗后常见的副作用。我们成功建立了多变量预测模型，该模型预测放射性反应的特异性达99%，敏感性为52.2%。

原文链接：

Patterns of Temporal Lobe Reaction and Radiation Necrosis after Particle Radiotherapy in Patients with Skull Base Chordoma and Chondrosarcoma—A Single-Center Experience