立体定向放射外科治疗海绵窦海绵状血管瘤的安全性及有效性

The safety and efficacy of stereotactic radiosurgery for cavernous sinus hemangioma

、全文阅读后筛选文献15篇,共收集155例患者资料,平均肿瘤体积14.7 cm3,无症状患者22例,有症状患者133例,其中39例患者有动眼神经麻痹,外展神经和视神经损伤患者分别有31例和28例。利用SPSS对文中数据进行统计学分析,分析其疗效及安全性。结果133例有症状患者经过立体定向放射外科治疗,20例症状消失,97例症状改善,其余14例患者情况稳定。影像学结果显示肿瘤消失患者9例,明显缩小101例,部分缩小27例,无变化13例。除2例患者外,其余患者均无不良反应。统计学结果显示患者不同症状缓解情况患者肿瘤体积及边缘剂量之间差异均无统计学意义(P>0.05),病灶影像学变化不同患者的肿瘤体积及边缘剂量之间比较,差异均无统计学意义(P>0.05)。单独接受立体定向放射外科治疗后患者临床症状缓解率高于手术联合立体定向放射外科治疗组患者(96.8%vs 69.4%),差异具有统计学意义(χ2=15.367,P<0.001)。结论立体定向放射外科是治疗海绵窦海绵状血管瘤的有效治疗方法。

Objective To perform a systematic review and meta-analysis for exploring the safety and efficacy of stereotactic radiosurgery for cavernous sinus hemangioma.Methods Fifteen studies were identified through a literature search and the information of 155 patients was recorded.Clinical outcomes and the tumor response were the primary measurements of interest.The mean tumor volume was 14.7 cm3.Twenty-two patients(14.2%)were asymptomatic and 133(85.8%)were symptomatic.Thirty-nine(35.8%)patients had cranial nerve III palsy while 31(28.4%)patients and 28(25.7%)patients had VI and II cranial nerve palsy,respectively.Results Among the 133 patients with symptoms,symptoms of 20(15.3%)patients disappeared while 97(74.0%)of them improved after the treatment.The symptoms of the remaining patients(10.79%,14/131)were stable.The imaging results showed that there were 9 patients with tumor disappearance,101 patients with significant reduction of tumor volume,27 patients with partially reduced tumor volume and 13 patients without change.No adverse effects were observed in these patients except two patients.The improvement of symptom is not related to the volume or isodose(P>0.05).The shrunk of volume is not related to the volume or isodose(P>0.05).The improvement of symptoms of patients was better for patients with radiosurgery alone than the patients received surgery before radiosurgery(96.8%vs 69.4%,χ2=15.367,P<0.001).Conclusion The meta-analysis indicated the stereotactic radiosurgery could be the optimal treatment therapy for cavernous sinus hemangioma.