Wednesday, December 28, 2016

Gamma Knife Radiosurgery for Recurrent Medulloblastoma

This 7 years old boy from Faisalabad, biopsy proven Medulloblastoma WHO G-IV, had undergone insertion of VP Shunt on October 01, 2013 & excision of SOL on October 16, 2013 presented with complains of headache, ataxia & double vision since 2013 which improved after surgery. Patient had whole brain radiotherapy, in 30 fraction, from November 2013 to December 2013. Seven cycles of Chemotherapy completed in September 2014.  On clinical examination patient has no obvious neurological deficit. MRI brain with contrast dated January 08, 2015 shows interval increase in  dural based nodular lesion rising from the left tentorial leaf, suggestive of recurrence of disease. Patient referred us for Gamma Knife. Patient has following treatment,

Target
                 Location
             Prescription
             Volume
A


Recurrent Medulloblastoma
             16.0 Gy @  50 %

             

            
              5.0 cm³

Multiple isocenter with 18 & 08 mm collimator used in APS mode. The dose was consulted with the Radiation Oncologist and was delivered with Leksell Gamma Unit 4-C.  
At Gamma Knife Treatment.

  After 03 months.
                                                                                                   After 06 months.