Cystic craniopharyngiomaに対する内照射療法

概要

論文の詳細を見る
We are reporting the results of internal irradiation using P-32 chromic phosphate and Au-198 colloid for cystic craniopharyngiomas. The irradiation schedules were made by a newly developed dosimetric formula, by which the radiation dose can be calculated at the cyst wall and at the point far from the radioactive source as well as simultaneously. Using this formula, untoward effects of irradiation on surrounding brain tissues can be eliminated, especially in cases in which the cyst wall is thin and can be penetrated by beta emission. Eight cysts out of 6 cases with craniopharyngioma wcre treated in this series by injection of radioactive phosphate or gold into the cyst through Ommaya reservoir and tube which had been placed beforehand at the time of craniotomy. All cysts were effectively treated to climinate fluid retention or the collapse of the cyst for 3 to 33 months, which had been confirmed by follow-up conray cystography and computerized tomography. The effectiveness of irradiation was also shown histologically with a collapsed cyst removed at the second craniotomy. The side effect of irradiation, oculomotor palsy, was found only in a case with small cyst (5.0 ml of volume) at supra- and intrasellar region 10 days after the injection of 5 mc of P 32 chromic phosphate. The thickness of the cyst wall was less than 0.5 mm and the oculomotor nerves were thought to be adherent to the cyst wall by retrospective analysis. From these experiences, it was concluded that not only the amount of wall dose but also the thickness of cyst wall and the localization of the cyst were important factors for planning internal irradiation. Sufficient and safer doses to the cyst wall, which kills the tumor cells in the wall without side effects, would be between 9,000 to 30,000 rad for cystic craniopharyngiomas. Regarding the indications of internal irradiation, we are setting up some criteria to choose this method of treatment for cystic craniopharyngiomas. Large cysts ef more than 10 ml and which are thought to be difficult to remove radically, would be the first choice of this treatment. Another indication will be cases with recurrent cyst resisting to the previous treatments or cases with multiple cysts. In conclusion, internal irradiation is effective not only for cystic craniopharyngiomas but also is applicable to cystic intracranial tumors other than craniopharyngioma if the dosimetry is done accurately.
日本脳神経外科学会の論文
1979-05-15

Cystic craniopharyngiomaに対する内照射療法

スポンサーリンク

概要

著者

関連論文

スポンサーリンク