Article
Tumors of the craniocervical junction – a localization for adjuvant Gamma Knife treatment?
Stereotaktische Radiochirurgie als adjuvante Therapieoption bei Tumoren des kraniozervikalen Überganges
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Published: | April 11, 2007 |
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Objective: Despite the development of atraumatic microsurgical techniques and skull base approaches, tumors of the craniocervical junction still pose a major challenge. Due to the highly vulnerable vascular and neural structures, they are often only subtotally resected. They may represent an indication for adjuvant radiosurgery.
Methods: Between July 1992 and September 2001, 12 patients with a mean age of 48 years (range 15-68) received a postoperative radiosurgical treatment with the Gamma Knife. Nine patients had meningiomas, two had hemangioblastomas and one suffered from a chordoma. The median tumor volume was 3.8 ccm (range 0.79-15.6 ccm). Follow-up time ranged from 36-120 months (median 64). The tumor borders were covered with volume curves on the 45-60% isodose and received a marginal dosis of 12-15 Gy.
Results: Follow-up MR images revealed tumor shrinkage in 7 cases, constant volume in 3 cases and increased tumor size in 2 patients. Neurological examination showed improved status in 6 patients and unchanged status in 4 patients. Two patients complained of new neurological deficits.
Conclusions: Despite the difficult localization for stereotactic radiosurgery, tumors of the craniocervical junction and the foramen magnum may be an indication for this treatment option. Side effects are rare. The short hospitalization contributes to cost effectiveness in public health care.