预防颅骨或头皮肿瘤CyberKnife立体定向放射手术后斑片状脱发的实用指南：单一机构经验的回顾性分析。

IF 1.9 4区医学 Q3 NEUROIMAGING

Stereotactic and Functional Neurosurgery Pub Date : 2023-01-01 Epub Date: 2023-09-12 DOI:10.1159/000533555

David J Park, Neelan J Marianayagam, Ulas Yener, Armine Tayag, Louisa Ustrzynski, Sara C Emrich, Erqi Pollom, Scott Soltys, Antonio Meola, Steven D Chang

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引用次数: 1

摘要

简介：斑片状脱发是立体定向放射外科（SRS）对颅骨和/或头皮的常见不良反应，但目前尚无预防指南。本研究旨在调查颅骨或头皮病变患者SRS后斑片状脱发的发生率和结果，并制定预防指南。方法：该研究包括20名因颅骨或头皮病变接受CyberKnife SRS治疗的患者，共治疗了30个病变。SRS作为单一组分用于8个病变，低组分用于22个病变。SRS靶体积中位数为9.85 cc（范围：0.81-110.7 cc），处方剂量中位数为27 Gy（范围：16-40 Gy），分1-5个部分（中位数：3）给药。中位随访时间为15个月。结果：在30个治疗的病变中，11个导致斑片状脱发，19个没有。所有脱发病例均在12个月内痊愈，没有患者出现其他辐射不良反应。与没有脱发的病变相比，导致脱发的病变在上覆头皮上表现出显著更高的生物有效剂量（BED）和单次当量剂量（SFED）。BED和SFED分别超过60 Gy和20 Gy的患者出现斑片状脱发的可能性是低剂量患者的9.3倍。治疗病变的1年局部肿瘤控制率为93.3%。26个病变进行了化疗，其中11个病变接受了放射增敏剂治疗。然而，没有发现统计学上的显著差异。结论：总之，SRS是治疗治疗区域附近斑片状脱发的颅骨/头皮肿块的安全有效的治疗方法。将上覆头皮的BED限制在60 Gy以下，将SFED限制在20 Gy以下有助于在SRS治疗颅骨/头皮肿块期间预防斑片状脱发。临床医生可以利用这些信息告知患者脱发的风险和促成因素。

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Practical Guideline for Prevention of Patchy Hair Loss following CyberKnife Stereotactic Radiosurgery for Calvarial or Scalp Tumors: Retrospective Analysis of a Single Institution Experience.

Introduction: Patchy alopecia is a common adverse effect of stereotactic radiosurgery (SRS) on the calvarium and/or scalp, yet no guidelines exist for its prevention. This study aims to investigate the incidence and outcomes of patchy alopecia following SRS for patients with calvarial or scalp lesions and establish preventive guidelines. Methods: The study included 20 patients who underwent CyberKnife SRS for calvarial or scalp lesions, resulting in a total of 30 treated lesions. SRS was administered as a single fraction for 8 lesions and hypofractionated for 22 lesions. The median SRS target volume was 9.85 cc (range: 0.81–110.7 cc), and the median prescription dose was 27 Gy (range: 16–40 Gy), delivered in 1–5 fractions (median: 3). The median follow-up was 15 months. Results: Among the 30 treated lesions, 11 led to patchy alopecia, while 19 did not. All cases of alopecia resolved within 12 months, and no patients experienced other adverse radiation effects. Lesions resulting in alopecia exhibited significantly higher biologically effective dose (BED) and single-fraction equivalent dose (SFED) on the overlying scalp compared to those without alopecia. Patients with BED and SFED exceeding 60 Gy and 20 Gy, respectively, were 9.3 times more likely to experience patchy alopecia than those with lower doses. The 1-year local tumor control rate for the treated lesions was 93.3%. Chemotherapy was administered for 26 lesions, with 11 lesions receiving radiosensitizing agents. However, no statistically significant difference was found. Conclusion: In summary, SRS is a safe and effective treatment for patients with calvarial/scalp masses regarding patchy alopecia near the treated area. Limiting the BED under 60 Gy and SFED under 20 Gy for the overlying scalp can help prevent patchy alopecia during SRS treatment of the calvarial/scalp mass. Clinicians can use this information to inform patients about the risk of alopecia and the contributing factors.

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来源期刊

Stereotactic and Functional Neurosurgery 医学-神经成像

CiteScore

3.80

自引率

0.00%

发文量

审稿时长

3 months

期刊介绍： ''Stereotactic and Functional Neurosurgery'' provides a single source for the reader to keep abreast of developments in the most rapidly advancing subspecialty within neurosurgery. Technological advances in computer-assisted surgery, robotics, imaging and neurophysiology are being applied to clinical problems with ever-increasing rapidity in stereotaxis more than any other field, providing opportunities for new approaches to surgical and radiotherapeutic management of diseases of the brain, spinal cord, and spine. Issues feature advances in the use of deep-brain stimulation, imaging-guided techniques in stereotactic biopsy and craniotomy, stereotactic radiosurgery, and stereotactically implanted and guided radiotherapeutics and biologicals in the treatment of functional and movement disorders, brain tumors, and other diseases of the brain. Background information from basic science laboratories related to such clinical advances provides the reader with an overall perspective of this field. Proceedings and abstracts from many of the key international meetings furnish an overview of this specialty available nowhere else. ''Stereotactic and Functional Neurosurgery'' meets the information needs of both investigators and clinicians in this rapidly advancing field.