Brain Tumor Res Treat.  2014 Oct;2(2):56-61. 10.14791/btrt.2014.2.2.56.

Fractionated Gamma Knife Radiosurgery for Benign Perioptic Tumors: Outcomes of 38 Patients in a Single Institute

• Jee TK
• Seo HJ
• Im YS
• Kong DS
• Nam DH
• Park K
• Shin HJ
• Lee JI

• KMID: 2134272
• DOI: http://doi.org/10.14791/btrt.2014.2.2.56

Abstract

BACKGROUND
This study was performed to evaluate the efficacy and safety of fractionated Gamma Knife radiosurgery (GKRS) for perioptic lesions.
METHODS
Thirty-eight patients with perioptic tumors were treated at our institute from May 2004 to December 2008. All patients had a lesion in close contact with the optic apparatus. Twenty-four of these patients had undergone surgical resection before fractionated GKRS. Radiation was delivered in four sessions with 12 hours intervals between sessions. The mean target volume was 3,851 mm3 and the median cumulative marginal dose was 20 Gy. The median follow-up was 38.2 months. Visual acuity and visual fields were analyzed according to visual impairment score using the German Ophthalmological Society guidelines.
RESULTS
Tumor control was achieved in 35 (94.6%) of the 37 patients with available follow-up images. Progressive tumor growth was observed in two craniopharyngioma patients (5.4%). Favorable visual outcomes in the postoperative period were achieved in 94.7% of cases (36/38). Sixteen patients showed visual function after fractionated GKRS, twenty cases were stationary, and two patients showed visual function deterioration after GKRS.
CONCLUSION
GKRS is a safe and effective alternative to either surgery or fractionated radiotherapy for selected benign lesions that are adjacent to the optic apparatus.

Keyword

Gamma Knife radiosurgery; Fractionated radiosurgery; Stereotactic radiosurgery; Tumor control; Visual outcome

MeSH Terms

Craniopharyngioma
Follow-Up Studies
Humans
Postoperative Period
Radiosurgery*
Radiotherapy
Vision Disorders
Visual Acuity
Visual Fields

Figure

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  Fig. 1 A 26-year-old male patient (case No. 29) with a right orbital hemangioma underwent fractionated Gamma Knife radiosurgery. A comparison of the magnetic resonance images acquired before radiosurgery (A) and 15 months after radiosurgery (B) reveals a decrease in tumor volume. Visual field examination shows a field defect before radiosurgery (C) and only a small blind spot 12 months after radiosurgery (D).

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