Document Detail


Gamma Knife surgery of large meningiomas: early response to treatment.
MedLine Citation:
PMID:  19093071     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Gamma Knife treatment is traditionally limited to tumours with a diameter not exceeding 3-3.5 cm. The current paper presents 97 patients with meningiomas with a minimum volume of 10 cm(3), treated with a prescription dose of 12 Gy (or sometimes less to protect neighbouring structures). The post-treatment assessment of these patients, the early response to treatment and the complications of treatment are presented. METHODS: There were 97 patients, 70 females and 27 males. The mean age was 48.1 years (range 20.4-87.2 years). The mean follow-up was 54 months (range 25-86 months). All tumours had a volume of 10 cm(3) or more. The mean volume was 15.9 cm(3) (range 10.0-43.2 cm(3)). Post-treatment follow-up used quantitative and qualitative assessments, which are described. RESULTS: No tumour continued to grow. Twenty-seven were smaller and 72 unchanged in volume. Three patients suffered adverse radiation effects (defined as a new post-treatment oedema detected on the magnetic resonance image with or without contrast leakage). In one case this was silent. In two cases the clinical and radiological effects were temporary and resolved completely. CONCLUSIONS: It is suggested on the basis of this material that the dosimetry used here permits the safe Gamma Knife treatment of larger meningiomas within the range reported. The early radiological response is encouraging, but further follow-up is needed to check long term tumour control. A qualitative method of tumour volume assessment is presented. It seems to be a simpler and more reliable way of assessing tumour volume changes than other methods currently in routine use.
Authors:
J C Ganz; W A Reda; K Abdelkarim
Publication Detail:
Type:  Journal Article     Date:  2008-12-19
Journal Detail:
Title:  Acta neurochirurgica     Volume:  151     ISSN:  0942-0940     ISO Abbreviation:  Acta Neurochir (Wien)     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-26     Completed Date:  2009-04-09     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0151000     Medline TA:  Acta Neurochir (Wien)     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  1-8     Citation Subset:  IM    
Affiliation:
Gamma Knife Center Cairo, Nasser Institute, Shobra, Cairo, Egypt. jcganz@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Brain / pathology,  radiography
Brain Edema / etiology
Disease Progression
Dose-Response Relationship, Radiation
Female
Humans
Male
Meningeal Neoplasms / pathology,  radiography,  surgery*
Meningioma / pathology,  radiography,  surgery*
Middle Aged
Neoplasm Recurrence, Local / prevention & control
Outcome Assessment (Health Care) / methods
Postoperative Complications / physiopathology,  prevention & control
Radiation Dosage*
Radiosurgery / methods*,  statistics & numerical data
Retrospective Studies
Time
Treatment Outcome
Young Adult

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


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