伽码刀治疗胶质母细胞瘤疗效显著

Gamma Knife Treatment For Glioblastomas Shows Promising Results

来自科学日报（2009.11.03）的文章称：磁共振波普（MRS）和伽码刀相结合治疗胶质瘤疗效显著。上海东方医院神经外科魏社鹏

ScienceDaily (Nov. 3, 2009) ? Researchers from University Hospitals Case Medical Center report promising results from a cutting-edge research study that treated the aggressive brain tumors glioblastoma multiforme (GBM) using a novel type of imaging called MR spectroscopy coupled with high dose radiation in the form of Gamma Knife radiosurgery.

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与传统的放疗相比，这个磁共振波普（MRS）和伽码刀相结合的技术将胶质母细胞瘤病人的生存期平均延长了3.7个月。Douglas B认为，4个月的生存期延长相比于传统放疗的1年生存期还是有显著意义的。

多形性胶质母细胞瘤是最常见的和最具进展性的原发性脑肿瘤。其最大的特点在于手术切除之后的几个月内，该肿瘤会继续生长。是这种肿瘤最终在2009年的8月份是夺去了参议员爱德华肯尼迪的生命。

此次的II期临床试验研究中共有35例病人，时间为5年。病人首先行MRS检查来判断恶性胶质瘤中最具进展性的部分。这些区域然后施以伽码刀的集中照射治疗。之后病人被给以标准的传统放疗。

伽码刀是一种可以让内科医生施行放射外科手术的装置。这种无创伤的神经外科技术采用了强大剂量的放射线来瞄准和摧毁脑内病变，而使得病变周围的脑组织却能保持完好无损。这种工艺水平使得内科医生能够对那些通常不能手术的脑部病变进行手术治疗。

MRS是一种特殊的磁共振扫描，代谢复合物的峰值能被记录并定量在磁共振图像上。这些峰值包括胆碱峰，在有显著细胞更新的脑肿瘤位置，胆碱峰显著增高。而N-乙酰天冬氨酸（NAA）可见于神经组织，常被用来区分正常的神经细胞和胶质瘤细胞。

Einstein教授认为，还需要多中心的临床3期试验来对这一结果进行验证。

Patients" survival rates increased by almost four months (3.7 months) compared with patients who were treated with traditional conventional radiotherapy alone.

"The four month increase is quite significant as the median survival of patients treated with conventional radiotherapy alone is only one year," said Douglas B. Einstein, M.D., Ph.D., lead author of the study and Vice Chairman and Clinical Director of the Department of Radiation Oncology at University Hospitals Case Medical Center and Assistant Professor at Case Western Reserve University School of Medicine.

The results of this study were presented at the American Society for Radiation Oncology (ASTRO) meeting in Chicago on Nov. 2, 2009.

GBM is the most common and aggressive type of brain cancer,

and is notorious for growing back within months of surgery. It is the type of cancer that the late Sen. Edward Kennedy battled.

Thirty-five patients were enrolled in this Phase II, five-year study. Patients underwent MR spectroscopy imaging to non-invasively identify regions of the GBM tumor that were more aggressive than other areas. These regions were then targeted with high-dose radiation from a Gamma Knife. Treatment was then followed by standard conventional radiotherapy.

The Gamma Knife is an instrument that allows physicians to perform radiosurgery, a non-invasive neurosurgical procedure that uses powerful doses of radiation to target and treat diseased brain tissue while leaving surrounding tissue intact. The state-of-the art technology allows physicians to operate on brain lesions often considered inoperable.

MR spectroscopy involves a specialized MR scan where peaks of metabolic compounds can be identified and quantitated within the MR image. These peaks include choline which is elevated in areas of the MR image that have a high cell turnover such as an active brain tumor and NAA found in neuronal tissue and used to separate normal neuronal cells from the glioma brain tumor cells.

Given the positive finding from this study, a multi-center Phase III randomized trial is being designed, said Dr. Einstein.

 

 

本文链接：http://www.sciencedaily.com/releases/2009/11/091102171223.htm