Article

Role of Gamma Knife Radiosurgery in Multimodality Management of Craniopharyngioma.

M Abid Saleem, A Sattar M Hashim, Azher Rashid, Muhammed Ali

Department of Neurosurgery, Pakistan Gamma Knife and Stereotactic Radiosurgery Center, NeuroSpinal and Medical Institute, 100/1 Mansfield Street, M.A. Jinnah Road, Sadder, Karachi, 74400, Pakistan, .

Acta neurochirurgica. Supplement 01/2013; 116:55-60. DOI:10.1007/978-3-7091-1376-9_9

Source: PubMed

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ABSTRACT Objective: This retrospective study evaluated the efficacy and safety of the use of Gamma Knife Radiosurgery (GKS) along with other surgical procedures in the management of craniopharyngioma. Methods: Thirty-five patients (17 children and 18 adults) with craniopharyngioma were treated with GKS between May 2008 and August 2011. The age of the patients ranged from 2 to 53 years (mean 20 years). There were 26 males and 9 females. Craniopharyngiomas were solid in 7 patients, cystic in 4, and mixed in 24. Tumor size ranged from 1 to 33.3 cm(3) (mean 12 cm(3)). The prescription dose ranged from 8 to 14 Gy (mean 11.5 Gy). Maximum dose ranged from 16 to 28 Gy (mean 23 Gy). Before GKS 11 patients underwent subtotal resection of the neoplasm, 2 - neuroendocopic fenestration of the large cystic component, and 10 - stereotactic aspiration of the neoplastic cyst content. Results: The length of follow-up period varied from 6 to 36 months (mean 22 months). The tumor response rate and control rate were 77.1 % and 88.5 %, respectively. Clinical outcome was considered excellent in 10 cases, good in 17, fair in 4, and poor in 4. No one patient with normal pituitary function before GKS developed hypopituitarism thereafter. Deterioration of the visual function after treatment was noted in one patient. Conclusion: After GKS tumor control can be achieved in significant proportion of patients with craniopharyngioma. Treatment-related neurological morbidity in such cases is rare. Therefore, radiosurgery may be considered useful for management of these tumors.

Multisession stereotactic radiosurgery for large benign brain tumors of >3cm-early clinical outcomes.

Article: Multisession stereotactic radiosurgery for large benign brain tumors of >3cm-early clinical outcomes

Azhar Rashid, MBBS, FCPS Radiotherapy (PAK, Msc Oncology (UK, Muhammad Ali Memon, MCPS, Usman Ahmed, M.Phil Physics, Muhammad Abid Saleem, FCPS Neurosurgery (PAK,Amer Iqtidar Bhatti, MD in Radiology (PAK, Naveed Ahmed, FCPS Radiology (PAK, FRCR, Abdul Sattar M. Hashim, M.D, Ph.D

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ABSTRACT: Objective: To evaluate the clinical outcome of linear accelerator based multisession stereotactic radiosurgery (SRS) for large benign brain tumors of >3cm. Methods: Between June 2009 and May 2011, 35 patients having large benign brain tumors of >3cm (≥15 cm3) were treated by multisession stereotactic radiosurgery. This retrospective study was carried out at Neurospinal & Medical Institute Karachi. There were 17 (48.6 %) males and 18(51.4 %) females. Median age was 36 years (range: 13-65 years). Median target volume was 49.4 cm3 (range: 15-184 cm3). The median marginal dose was 25 Gy (range: 20–27.5Gy) prescribed to a median 75% isodose line (range: 65-100 %). Median number of 5 fractions were used ranging 3-5 fractions. Results: All the patients tolerated treatment very well. 21 (58.3%) patients had remarkable clinical improvement of neurological symptoms, 14 (38.9%) patients had stable symptoms, and only one patient had transient worsening of symptoms. No permanent neurological damage or radiation injury was seen. Radiologically, 9 (25.7%) patients achieved reduction in size of the tumor, 26(74.3 %) patients were having stable disease, and overall control rate was found to be 100 %. Median follow-up time from the end of SRS was 6.4 months (range: 1-22.5months). Conclusion: Linear accelerator based multisession stereotactic radiosurgery for large benign brain tumors of >3cm is effective and well tolerated. Key Words: Stereotactic radiosurgery (SRS), multi session SRS, brain tumors, linear accelerator, benign brain tumors, radiation injury.

Journal of Radiosurgery and SBRT Vol. 2 2012. 04/2012; vol.2(2012):29-40.