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Emerging Indications for Fractionated Gamma Knife Radiosurgery. | LitMetric

AI Article Synopsis

  • - Gamma Knife radiosurgery (GKRS) is a precise treatment for intracranial tumors but traditional methods can't be used for some cases that require multiple sessions due to their design limitations.
  • - The study focused on using a new, noninvasive immobilization system to treat patients needing fractionated GKRS for specific tumor types, including large benign tumors and those near critical structures like the optic nerve.
  • - Results showed that 34 patients had successful outcomes, with no severe side effects reported, including maintained or improved vision for patients with optic nerve tumors and preserved hearing for patients treated for vestibular schwannomas.

Article Abstract

Background: Gamma Knife radiosurgery (GKRS) allows for the treatment of intracranial tumors with a high degree of dose conformality and precision. There are, however, certain situations wherein the dose conformality of GKRS is desired, but single session treatment is contraindicated. In these situations, a traditional pin-based GKRS head frame cannot be used, as it precludes fractionated treatment.

Objective: To report our experience in treating patients with fractionated GKRS using a relocatable, noninvasive immobilization system.

Methods: Patients were considered candidates for fractionated GKRS if they had one or more of the following indications: a benign tumor >10 cc in volume or abutting the optic pathway, a vestibular schwannoma with the intent of hearing preservation, or a tumor previously irradiated with single fraction GKRS. The immobilization device used for all patients was the Extend system (Leksell Gamma Knife Perfexion, Elekta, Kungstensgatan, Stockholm).

Results: We identified 34 patients treated with fractionated GKRS between August 2013 and February 2015. There were a total of 37 tumors treated including 15 meningiomas, 11 pituitary adenomas, 6 brain metastases, 4 vestibular schwannomas, and 1 hemangioma. At last follow-up, all 21 patients treated for perioptic tumors had stable or improved vision and all 4 patients treated for vestibular schwannoma maintained serviceable hearing. No severe adverse events were reported.

Conclusion: Fractionated GKRS was well-tolerated in the treatment of large meningiomas, perioptic tumors, vestibular schwannomas with intent of hearing preservation, and in reirradiation of previously treated tumors.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5017892PMC
http://dx.doi.org/10.1227/NEU.0000000000001227DOI Listing

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