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Fractionated gamma knife radiosurgery for benign perioptic tumors: outcomes of 38 patients in a single institute.

Jee TK, Seol HJ, Im YS, Kong DS, Nam DH, Park K, Shin HJ, Lee JI - Brain Tumor Res Treat (2014)

Bottom Line: Favorable visual outcomes in the postoperative period were achieved in 94.7% of cases (36/38).Sixteen patients showed visual function after fractionated GKRS, twenty cases were stationary, and two patients showed visual function deterioration after GKRS.GKRS is a safe and effective alternative to either surgery or fractionated radiotherapy for selected benign lesions that are adjacent to the optic apparatus.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT

Background: This study was performed to evaluate the efficacy and safety of fractionated Gamma Knife radiosurgery (GKRS) for perioptic lesions.

Methods: Thirty-eight patients with perioptic tumors were treated at our institute from May 2004 to December 2008. All patients had a lesion in close contact with the optic apparatus. Twenty-four of these patients had undergone surgical resection before fractionated GKRS. Radiation was delivered in four sessions with 12 hours intervals between sessions. The mean target volume was 3,851 mm(3) and the median cumulative marginal dose was 20 Gy. The median follow-up was 38.2 months. Visual acuity and visual fields were analyzed according to visual impairment score using the German Ophthalmological Society guidelines.

Results: Tumor control was achieved in 35 (94.6%) of the 37 patients with available follow-up images. Progressive tumor growth was observed in two craniopharyngioma patients (5.4%). Favorable visual outcomes in the postoperative period were achieved in 94.7% of cases (36/38). Sixteen patients showed visual function after fractionated GKRS, twenty cases were stationary, and two patients showed visual function deterioration after GKRS.

Conclusion: GKRS is a safe and effective alternative to either surgery or fractionated radiotherapy for selected benign lesions that are adjacent to the optic apparatus.

No MeSH data available.


Related in: MedlinePlus

A 26-year-old male patient (case No. 29) with a right orbital hemangioma underwent fractionated Gamma Knife radiosurgery. A comparison of the magnetic resonance images acquired before radiosurgery (A) and 15 months after radiosurgery (B) reveals a decrease in tumor volume. Visual field examination shows a field defect before radiosurgery (C) and only a small blind spot 12 months after radiosurgery (D).
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Figure 1: A 26-year-old male patient (case No. 29) with a right orbital hemangioma underwent fractionated Gamma Knife radiosurgery. A comparison of the magnetic resonance images acquired before radiosurgery (A) and 15 months after radiosurgery (B) reveals a decrease in tumor volume. Visual field examination shows a field defect before radiosurgery (C) and only a small blind spot 12 months after radiosurgery (D).

Mentions: Two patients with functional pituitary adenoma were recruited in this series. In one patient with McCune-Albright syndrome, growth hormone levels decreased significantly at 23 months after fractionated GKRS with tumor shrinkage, though levels did not normalize. In one prolactinoma patient, the tumor volume was stationary. However, serum prolactin levels were normalized after administration of bromocriptine. No permanent complication or treatment-related morbidity occurred. A representative case with a orbital hemangioma is shown in Fig. 1.


Fractionated gamma knife radiosurgery for benign perioptic tumors: outcomes of 38 patients in a single institute.

Jee TK, Seol HJ, Im YS, Kong DS, Nam DH, Park K, Shin HJ, Lee JI - Brain Tumor Res Treat (2014)

A 26-year-old male patient (case No. 29) with a right orbital hemangioma underwent fractionated Gamma Knife radiosurgery. A comparison of the magnetic resonance images acquired before radiosurgery (A) and 15 months after radiosurgery (B) reveals a decrease in tumor volume. Visual field examination shows a field defect before radiosurgery (C) and only a small blind spot 12 months after radiosurgery (D).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4231616&req=5

Figure 1: A 26-year-old male patient (case No. 29) with a right orbital hemangioma underwent fractionated Gamma Knife radiosurgery. A comparison of the magnetic resonance images acquired before radiosurgery (A) and 15 months after radiosurgery (B) reveals a decrease in tumor volume. Visual field examination shows a field defect before radiosurgery (C) and only a small blind spot 12 months after radiosurgery (D).
Mentions: Two patients with functional pituitary adenoma were recruited in this series. In one patient with McCune-Albright syndrome, growth hormone levels decreased significantly at 23 months after fractionated GKRS with tumor shrinkage, though levels did not normalize. In one prolactinoma patient, the tumor volume was stationary. However, serum prolactin levels were normalized after administration of bromocriptine. No permanent complication or treatment-related morbidity occurred. A representative case with a orbital hemangioma is shown in Fig. 1.

Bottom Line: Favorable visual outcomes in the postoperative period were achieved in 94.7% of cases (36/38).Sixteen patients showed visual function after fractionated GKRS, twenty cases were stationary, and two patients showed visual function deterioration after GKRS.GKRS is a safe and effective alternative to either surgery or fractionated radiotherapy for selected benign lesions that are adjacent to the optic apparatus.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT

Background: This study was performed to evaluate the efficacy and safety of fractionated Gamma Knife radiosurgery (GKRS) for perioptic lesions.

Methods: Thirty-eight patients with perioptic tumors were treated at our institute from May 2004 to December 2008. All patients had a lesion in close contact with the optic apparatus. Twenty-four of these patients had undergone surgical resection before fractionated GKRS. Radiation was delivered in four sessions with 12 hours intervals between sessions. The mean target volume was 3,851 mm(3) and the median cumulative marginal dose was 20 Gy. The median follow-up was 38.2 months. Visual acuity and visual fields were analyzed according to visual impairment score using the German Ophthalmological Society guidelines.

Results: Tumor control was achieved in 35 (94.6%) of the 37 patients with available follow-up images. Progressive tumor growth was observed in two craniopharyngioma patients (5.4%). Favorable visual outcomes in the postoperative period were achieved in 94.7% of cases (36/38). Sixteen patients showed visual function after fractionated GKRS, twenty cases were stationary, and two patients showed visual function deterioration after GKRS.

Conclusion: GKRS is a safe and effective alternative to either surgery or fractionated radiotherapy for selected benign lesions that are adjacent to the optic apparatus.

No MeSH data available.


Related in: MedlinePlus