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Long-term experience with fractionated stereotactic radiotherapy in pharmacoresistant epilepsy: Neurological and MRI changes.
MedLine Citation:
PMID:  22130038     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: Radiotherapy is an option in patients with difficult-to-treat epilepsy in which pharmacological and surgical alternatives have been exhausted. However, little is known about the long-term efficacy and side effects of radiotherapy in this context. Hence, we report for the first time on the long-term outcome (median 10 years) of fractionated stereotactic radiotherapy (FSRT) in 11 patients with drug-resistant epilepsy in a retrospective study. Primary endpoint is tolerability concerning neurological and MRI findings, secondary endpoint seizure frequency. PATIENTS AND METHODS: FSRT was performed in 11 patients with cryptogenic or symptomatic epilepsy from 1996 to 2009 using a conventional linear accelerator (LINAC) in seven cases and a dedicated NOVALIS(®) LINAC in four. The biologically equivalent dose ranged from 26.3 to 58.3Gy (α/β=10). RESULTS: (1) None of the patients developed temporary or permanent neurological deficits. No MRI changes occurred. (2)Treatment resulted in improvement of seizure frequency in seven patients, five of them had a decrease in seizure frequency, and two of them were seizure-free at last follow-up. CONCLUSIONS: If radiation is administered with proper fractionation, dose prescription and target volume definition, long-term neurological side effects are unlikely. (2) Radiotherapy has the potential to control the frequency and intensity of seizures in epilepsy patients.
Authors:
Christophe Rauch; Sabine Semrau; Rainer Fietkau; Stefan Rampp; Burkhard Kasper; Hermann Stefan
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-28
Journal Detail:
Title:  Epilepsy research     Volume:  -     ISSN:  1872-6844     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-12-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703089     Medline TA:  Epilepsy Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier B.V. All rights reserved.
Affiliation:
Epilepsy Center Erlangen, Department of Neurology, University of Erlangen-Nuremberg, Germany.
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