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Title   악성 뇌종양의 분할정위 방사선치료 : 임상적 응용 예비적 결과 ( Fractionated Stereotactic Radiation Therapy for Intracranial Malignant Tumor : Preliminary Results of Clinical Application )
Publicationinfo   1998 Jan; 030(03): 583-591.
Key_word   Fractionated stereotactic radiation therapy, Relocatable head frame
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Abstract   Purpose: Fractionated stereotactic radiation therapy(FSRT) is a new modality that combines the accurate focal dose delivery of stereotactic radiosurgery with the biological advantages of conventional radiotherapy. We report our early experience using FSRT for intracranial malignant tumor. Materials and Methods: Between October 1995 and December 1996, 16 patients(9 males and 7 females aged between 10~64 years) with central nerve system malignancy were treated using FSRT. Sixteen patients had the following diagnosis: 6 high-grade gliomas, 1 pineoblastoma, 4 germinomas, 2 medulloblastomas, and 3 solitary brain metastases. Using the Gill-Thomas-Cosman relocatable head frame and multiple non-coplanar therapy, the daily dose of 2 Gy(3 Gy in metastasis) was irradiated at 85~100% isodose surface. Results: Although the follow-up period is relatively short(range; 2~18 months), post- treatment clinical courses in 16 patients have been consistent with changes similar to those found after conventional radiation therapy. No significant adverse effects were observed in our neurological and radiological studies. Four out of 5 patients with high grade glioma died from progressive disease, surviving from 7 to 17 months(median 14 months), but patients with pineoblastoma, germinoma and medulloblastoma showed no evidence of recurrence. All patients with metastasis obtained a neurologic response, but two among them died with extracranial progression and one die from multiple intracranial metastasis.In overall patient setup with scalp measurements, reproducibility was found to have mean of 1.1¡¾0.6 mm from the baseline reading. Conclusion: FSRT and relocatable stereotactic head frames were well tolerated with minimal transient acute side effects. Subacute or late complications were not observed, because the follow-up period was short. We expect that FSRT might be a good indication for; recurrent disease with previous radiation therapy history, tumors of relatively large volume, lesions adjacent to radiosensitive organs, and as a boost, following conventional radiation therapy.
저 자   김대용(Dae Young Kim),안용찬(Yong Chan Ahn),허승재(Seung Jae Huh),최동락(Dong Rak Choi),이정일(Jung Il Lee),김종현(Jong Hyun Kim),신형진(Hyung Jin Shin),임도훈(Do Hoon Lim),우홍균(Hong Gyun Wu)