Document Detail


Factors influencing early complications following Gamma Knife radiosurgery. A prospective study.
MedLine Citation:
PMID:  12007277     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The factors influencing early complications following Gamma Knife radiosurgery have not been definitely established. We report a prospective study evaluating the incidence of early complications (occurring within 3 months of radiosurgery) and various factors associated with early complications following stereotactic Gamma Knife radiosurgery for intracranial lesions. PATIENTS AND METHODS: Seventy-nine previously unirradiated consecutive adult patients (82 lesions: arteriovenous malformations 35, benign tumors 43, metastases 4) treated by Gamma Knife radiosurgery were studied between May 1997 and August 1998. The median target volume was 4.8 cm(3). The median dose of 15 Gy was prescribed to the 50% isodose. Patients were evaluated clinically and radiologically (with CT/MRI/SPECT) at 3-month intervals for the 1st year and 6 monthly thereafter. Complications were further divided as immediate (occurring within 24 h) or acute (occurring from 1 day to 3 months). RESULTS: Early complications were observed in 19/79 (24.0%) patients. These included immediate in 10 (12.7%) and acute complications in 9 (11.3%) patients and were characterized by headache, nausea/vomiting, vertigo and seizures. No severe early complications were observed. Radiological changes in the form of perilesional edema were seen in 8/82 (9.8%) lesions. Maximum target diameter >25 mm was the only factor significantly associated with early complications by univariate analysis (p = 0.0335). Multivariate analysis revealed maximum target diameter >25 mm and prescribed dose >20 Gy to be significantly associated with early complications (p = 0.0442 and p = 0.0083, respectively). CONCLUSION: Up to one fourth of the patients undergoing Gamma Knife radiosurgery for intracranial lesions can experience self-limiting early toxicity. The selection of targets with small diameter and volume may reduce the risk of early complications following Gamma Knife radiosurgery.
Authors:
N S Majhail; S Chander; V S Mehta; P K Julka; T Ganesh; G K Rath
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Stereotactic and functional neurosurgery     Volume:  76     ISSN:  1011-6125     ISO Abbreviation:  Stereotact Funct Neurosurg     Publication Date:  2001  
Date Detail:
Created Date:  2002-05-14     Completed Date:  2002-07-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8902881     Medline TA:  Stereotact Funct Neurosurg     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  36-46     Citation Subset:  IM    
Copyright Information:
Copyright 2002 S. Karger AG, Basel
Affiliation:
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India. nsmajhail@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Brain Neoplasms / surgery
Female
Follow-Up Studies
Headache / etiology
Humans
Male
Middle Aged
Multivariate Analysis
Postoperative Complications* / physiopathology
Postoperative Nausea and Vomiting / etiology
Proportional Hazards Models
Prospective Studies
Radiosurgery / methods,  statistics & numerical data*
Seizures / etiology
Vertigo / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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