The Role of Teleradiotherapy in the Management of Craniopharygioma

遠隔放射治療在顱咽管瘤治療上所扮演的角色

劉裕明(Yu-Ming Liu) ； 王令瑋(Ling-Wei Wang) ； 顏上惠(Sang-Hue Yen) ； 潘宏基(David H. C. Pan) ； 李良雄(Liang-Shong Lee) ； 陳光耀(Kuang Y. Chen)

《放射治療與腫瘤學》 1卷4期 (1994/12) Pp. 309-319

https://doi.org/10.6316/TRO/199401(4)309

摘要

目的：就本院治療顱咽管瘤之經驗作一分析，同時比較各治療方法之結果。
方法與材料：於1980至1991年間，總計有41位顱咽管患者於台北榮民總院接受治療。有25位患者接受全切除手術（第一組）,6位接受部份切除（第二組）,6位接受部份切除及放射治療（第三組）,4位只接受放射治療（第四組），此外有16位復發息者接受後援放射治療-放射治療是經由10MV光子或鈷60射線給予，每週五次，每次2Gy，總腫瘤輻射劑量為49-63Gy（中值為60Gy）。
結果：五年無疾病進行存活率為41.3%，分別是25.8%（一組）,13.3%（二組）,100%（三組），及75%（四組）(p=0.0231)。復發患者後援治療之五年控制率為81.3%。其中第三組，第四組及復發患者之腫瘤輻射劑量分別為52,60及53cGy。第一，二，三及四組患者之中值腫瘤控制期為11,8,50及82個月而尿崩併發症則分別為56%,50%,33%及0%。
結論：總結來說，在顱咽管瘤之治療上，放射線治療無論是在術後治療，復發後之後援治療或是主要治療上皆扮演著重要的角色。而部份切除手術加上術後放射治療不但有極佳的治療效果且有低併發症率。

關鍵字

顱咽管瘤 ； 放射治療 ； 全切除 ； 部份切除 ； 復發 ； 後援治療

並列摘要

Purpose: The purpose of this study was to evaluate the effectiveness of teleradiotherapy in the treatment of primary and recurrent craniopharygioma patients treated at the Veterans General Hospital-Taipei.
Materials and Methods: Between 1980 and 1991, 41 patients received primary management of craniopharyngioma in the VGH-Taipei. Gross total removal of tumor was performed in 25 patients (Group Ⅰ). Six patients had subtotal removal of tumor (Group Ⅱ), 6 patients had subtotal removal with postoperative radiotherapy (Group Ⅲ). Four patients had teleradiotherapy alone Group Ⅳ). Sixteen patients out of the 19 patients from Group Ⅰ and Group Ⅱ with recurrent tumors received salvage radiotherapy. Median tumor dose prescribed at the 90% isodose volume were 52, 60 and 53 Gy for Group Ⅲ, Ⅳ and recurrent tumors, respectively. The fraction size was 2.0 Gy. Either 10 MV or cobalt 60 was used.
Result: Of five-year progression-free survival was 41.3% for the whole series, and 25.8%, 13.3%, 100%, 75% for Groups Ⅰ, Ⅱ, Ⅲ and Ⅳ, respectively (p-0.0231). The actuarial five-year local control rate after salvage radiotherapy for recurrent disease was 81.3%. The median tumor control duration were 11, 8, 50, 82 months. Rates of diabetes insipidus were 56%, 50%, 33%, 0% for Group Ⅰ, Ⅱ, Ⅲ and Ⅳ, respectively.
Conclusion: This study shows that definitive, adjuvant and salvage radiotherapy all lead to significant improvement in local control of craniopharyngioma with few complications. Postoperative radiotherapy is also highly recommended for patients treated with subtotal resection of tumor.

並列關鍵字

Craniopharyngioma ； Radiotherapy ； Total removal ； Subtotal removal ； Recurrence ； Salvage ； Progression free survival ； Local control