کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
340480 548307 2016 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Low-dose radiosurgery or hypofractionated stereotactic radiotherapy as treatment option in refractory epilepsy due to epileptogenic lesions in eloquent areas – Preliminary report of feasibility and safety
ترجمه فارسی عنوان
رادیوتراپی کم دوز یا رادیوتراپی استریوتاکتیک هیپوفراکسیون شده به عنوان گزینه درمان در صرع مقاوم به علت ضایعات اپیلوتوژیکی در مناطق فجیع - گزارش مقدماتی امکان سنجی و ایمنی
کلمات کلیدی
SRS، رادیو تراپی استریوتاکتیک ؛ SRT، رادیوتراپی استریوتاکتیک ؛ PTV، برنامه ریزی حجم هدف؛ CTV، حجم هدف بالینی؛ اندام در معرض خطر؛ شتاب دهنده خطی؛ MRI، تصویربرداری رزونانس مغناطیسی؛ RT، پرتودرمانی؛ Gy، خاکستری؛ EEG، الکتروانسفالوگ
موضوعات مرتبط
علوم زیستی و بیوفناوری علم عصب شناسی علوم اعصاب رفتاری
چکیده انگلیسی


• Non-ablative stereotactic irradiation is a promising treatment option for eloquent epileptogenic lesions.
• There were no side effects or neurological deficits after non-ablative stereotactic irradiation.
• Longer follow-up and larger prospective studies are needed.

PurposeThe eradication of epileptogenic lesions (e.g. focal cortical dysplasia) can be used for treatment of drug-resistant focal epilepsy, but in highly eloquent cortex areas it can also lead to a permanent neurological deficit. In such cases the neuromodulation effect of low-dose high-precision irradiation of circumscribed lesions may represent an alternative therapy.MethodA total of 10 patients with eloquent localized lesions causing pharmacoresistant focal epilepsy were prospectively identified. After informed consent, six patients agreed and were treated with risk adapted low-dose radiosurgery (SRS) or hypofractionated stereotactic radiotherapy (hfSRT). Comprehensive data concerning treatment modalities and outcome after short-term follow up (mean = 16.3 months) were prospectively collected and evaluated.ResultsFrom the six patients, two patients were treated with hfSRT (marginal dose 36 Gy) and four with SRS (marginal dose 13 Gy). Clinical target volume (CTV) ranged from 0.70 ccm to 4.32 ccm. The short-term follow-up ranged from 6 to 27 months. There were no side effects or neurological deficits after treatment. At last available follow-up two patients were seizure-free, one of them being off antiepileptic drugs. The seizure frequency improved in one and remained unchanged in three patients.ConclusionTreatment of eloquent localized epileptogenic lesions by SRS and hfSRT showed no adverse events and an acceptable seizure outcome in this small prospective patient series. The relatively short-term follow-up comprises one of the study's drawbacks and therefore a longer follow-up should be awaited in order to evaluate the neuromodulation effect of the treatment. These preliminary results may however justify the initiation of a larger prospective trial investigating whether focused low-dose stereotactic irradiation could be an option for lesions in eloquent brain areas.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Seizure - Volume 36, March 2016, Pages 57–62
نویسندگان
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