Artikel
Gamma knife radiosurgery for brainstem cavernomas
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Autoren
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Selcuk Peker
- Acibadem University School of Medicine, Department of Neurosurgery, Istanbul, Turkey
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Aysegul Ucuncu Kefeli
- Marmara University School of Medicine, Department of Radiation Oncology, Istanbul, Turkey
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Meric Sengoz
- Acibadem University School of Medicine, Department of Radiation Oncology, Istanbul, Turkey
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M. Necmettin Pamir
- Acibadem University School of Medicine, Department of Neurosurgery, Istanbul, Turkey
| Veröffentlicht: | 13. Mai 2014 |
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Gliederung
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Objective: The authors performed a retrospective review of safety and efficacy of Gamma Knife radiosurgery (GKRS) for the treatment of brainstem cavernomas (CMs).
Method: Between 2007 and 2011, 30 patients (19 males and 11 females) with symptomatic CMs of the brainstem underwent Gamma Knife surgery. The mean patient age was 40 years, and all patients had suffered at least 1 symptomatic hemorrhage (range 1-3) before radiosurgery. Prior to SRS, 5 patients (17%) had undergone attempted resection. The mean volume of the malformation treated was 0.66 ml, and the median prescribed marginal radiation dose was 12 Gy.
Results: The mean follow-up period was 31.2 months. The pre-GKS annual hemorrhage rate was 9.4%, excluding the first hemorrhage, over a total of 74.3 patient-years. Following SRS, 1 hemorrhage was observed after 12 months of treatment (1.3% annual hemorrhage rate). During follow-up 17 patients (57%) showed improvement, 11 (37%) stabilized, and 2 (7%) experienced progression of neurological symptoms. None of the patients experienced new neurological deficits as a result of adverse radiation effects following GKRS.
Conclusions: The results of this study support a role for the use of GKRS for symptomatic CMs of the brainstem. It is relatively safe and appears to reduce rebleeding rates in this high-surgical-risk location.
