gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Interstitial stereotactic radiosurgery for lesional epilepsy

Interstitielle Radiochirurgie in der Behandlung läsionaler Epilepsien

Meeting Abstract

Suche in Medline nach

  • H. Zaki - Department of Neurosurgery, The University of Liverpool, Liverpool /UK
  • T. Smith - Department of Neurosurgery, The University of Liverpool, Liverpool /UK
  • K. Kopitzki - Department of Neurosurgery, The University of Liverpool, Liverpool /UK
  • corresponding author Peter-Christian Warnke - Department of Neurosurgery, The University of Liverpool, Liverpool /UK

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMI.03.10

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2004/04dgnc0267.shtml

Veröffentlicht: 23. April 2004

© 2004 Zaki et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Small circumscribed low-grade gliomas mainly present with intractable epilepsy. Interstitial stereotactic radiosurgery as an alternative to surgery has been effective for temporal lesional epilepsy. We performed a study on extra temporal lesional epilepsy using interstitial radiosurgery.

Methods

23 patients with histologically proven low-grade gliomas have been studied with a median follow-up of 16.2 months after Iodine-125 interstitial radiosurgery. Maximum tumour diameter was 3.5cm. All patients were treated with 60Gy to the tumour margin. Dose rate was 10cGy per hour. Follow-up was done clinically with MRs and a comparison of pre-radiosurgery to post-radiosurgery Proton-MR spectroscopy every 6 months.

Results

Out of 23 patients, 19 have become seizure free (Engel class I) 3 patients had a significant, more than 75% reduction of seizure frequency (Engel class II) and 1 patient had no change. According to the MacDonald classification 4 patients had a complete response. 17 patients had a partial response. 2 patients had stable disease. All patients with a complete response had Engel class I outcome and the other 15 patients with Engel class I outcome had partial responses. The choline/creatinine ratio of tumours dropped from a median of 1.62 ± .4 before radiosurgery to 1.02 ± .31 after radiosurgery (3 month follow-up) in patients with Engel class I with no change (1.38 ± .4) in the rest.

Conclusions

Interstitial stereotactic radiosurgery in small circumscribed low-grade gliomas is not only an efficient tumour treatment but highly effective for the treatment of concomitant epilepsy. Furthermore MR spectroscopy might allow to predict seizure outcome early after interstitial radiosurgery using the choline/creatinine equation.