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Emergency irradiation with 3.4 Gy/2f in sellar/suprasellar germinoma patients with rapid visual acuity decline

摘要:

Background:Rapid visual acuity (VA) decline was a common complaint in patients with sellar/suprasellar germinoma.In our hospital,3.4 Gy/2f of emergency irradiation was applied to save patient VA and enable subsequent chemoradiotherapy.This study aimed to investigate the efficacy of emergency irradiation with 3.4 Gy/2f in patients with sellar/suprasellar germinoma who had rapid VA decline.Methods:From January 2014 to December 2017,33 patients with sellar/suprasellar germinoma who complained of VA decline within 3 months received 3.4 Gy/2f of emergency irradiation in Beijing Tiantan Hospital.The best-corrected VA (BCVA) and mean deviation (MD) were measured.Correlations between visual function change and clinical factors,including age at diagnosis,duration of VA decline,extent of tumor regression,serum level of tumor markers,were analyzed.Results:Among 33 patients with sellar/suprasellar germinoma,the median diameter and volume of sellar/suprasellar lesions were 32 mm (range:5-55 mm) and 12.9 cm3 (range 0.6-58.5 cm3),respectively.Data on pre-and post-emergency-irradiation BCVA were obtained in 32 patients.For the right eyes,BCVA was improved in 23 patients (71.9%),unchanged in 7 (21.9%),and worsened in 2 (6.2%);and for the left eyes,these numbers were 27 (84.4%),4 (12.5%),and 1 (3.1%),respectively.In terms of the logarithm of the minimum angle of resolution (logarithm of the minimum angle of resolution =Log (1/BCVA) score,the improvement was significant in both eyes (P < 0.001).In terms of MD,six patients had paired data and the improvement was marginal in the right eyes (P =0.068) and significant in the left eyes (P =0.043).However,no clinical factor was found to have correlation with visual function improvement.Conclusion:In sellar/suprasellar germinoma patients with VA decline,3.4 Gy/2f of emergency irradiation was effective in improving visual function.

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作者单位: Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China [1] Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China [2] Department of Ophthalmology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China [3]
期刊: 《中华医学杂志(英文版)》2019年132卷17期 2073-2078页 SCIMEDLINEISTICCSCDBP
栏目名称: Original Articles
DOI: 10.1097/CM9.0000000000000315
发布时间: 2019-10-29
基金项目:
This study was supported by a grant from Capital Foundation of Medical Development
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