Risk of injury to cranial nerves after gamma knife radiosurgery for skull base meningiomas: experience in 88 patients

Morita, Akio; Coffey, Robert J.; Foote, Robert L.; Schiff, David; Gorman, Deborah A.

doi:10.3171/jns.1999.90.1.0042

Cited by 311 publications

(139 citation statements)

References 18 publications

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“…Consistent with our experience, Morita et al found one patient to have permanent new oculomotor palsy following application of 10 Gy to the cavernous sinus. 50 Prevailing reports stated that the fifth cranial nerve seems to tolerate doses of up to 20 Gy, 15 17 19 30 50 but the new onset of transient trigeminal neuralgia following administration of 12-17 Gy to the trigeminal nerve was observed in two patients of our series.…”

Section: Discussionmentioning

confidence: 83%

Long-Term Experience of Gamma Knife Radiosurgery for Benign Skull Base Meningiomas

Kreil¹,

Eustacchio²,

Weigl³

et al. 2007

Skull Base

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Section: Discussionmentioning

confidence: 83%

Long-Term Experience of Gamma Knife Radiosurgery for Benign Skull Base Meningiomas

Kreil¹,

Eustacchio²,

Weigl³

et al. 2007

Skull Base

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“…However, there are certain restrictions associated with this technique. It is not possible to treat lesions with a diameter > 3.5 cm (21,22); in addition, treatment delivery in a single dose presents a risk of further deterioration in neuropathy (6,7,(22)(23)(24)(25)(26) that can result in loss of the optic nerve. Although the functional results of the various studies published show significant postoperative improvement, this is nevertheless not as impressive as the potential improvement offered by FSR.…”

Section: Discussionmentioning

confidence: 99%

Fractionated Stereotactic Radiotherapy Treatment of Cavernous Sinus Meningiomas: A Study of 100 Cases

Litré

Colin

Noudel

et al. 2009

International Journal of Radiation Oncology*Biology*Physics

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Purpose: We discuss our experiences with fractionated stereotactic radiotherapy (FSR) in the treatment of cavernous sinus meningiomas. Methods and Materials: From 1995 to 2006, we monitored 100 patients diagnosed with cavernous sinus meningiomas; 84 female and 16 male patients were included. The mean patient age was 56 years. The most common symptoms were a reduction in visual acuity (57%), diplopia (50%), exophthalmy (30%), and trigeminal neuralgia (34%). Surgery was initially performed on 26 patients. All patients were treated with FSR. A total of 45 Gy was administered to the lesion, with 5 fractions of 1.8 Gy completed each week. Patient treatment was performed using a Varian Clinac linear accelerator used for cranial treatments and a micro-multileaf collimator. Results: No side effects were reported. Mean follow-up period was 33 months, with 20% of patients undergoing follow-up evaluation of more than 4 years later. The tumor control rate at 3 years was 94%. Three patients required microsurgical intervention because FSR proved ineffective. In terms of functional symptoms, an 81% improvement was observed in patients suffering from exophthalmy, with 46% of these patients being restored to full health. A 52% improvement was observed in diplopia, together with a 67% improvement in visual acuity and a 50% improvement in type V neuropathy. Conclusions: FSR facilitates tumor control, either as an initial treatment option or in combination with microsurgery. In addition to being a safe procedure with few side effects, FSR offers the significant benefit of superior functional outcomes. Ó 2009 Elsevier Inc.

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“…The selection of this treatment protocol (total dose, number of sessions, and dose per session) was based on the knowledge of optic nerve tolerance to single-session radiosurgery 22,23,27,28) and experience treating the anterior optic pathways and other cranial nerves with multisession radiosurgery 1,9,32) . The aim of fractionated stereotactic radiosurgery is to reduce radiation injury to the surrounding structures and to be able to make radiation field be broader.…”

Section: Discussionmentioning

confidence: 99%

Stereotactic Radiosurgery with the CyberKnife for Pituitary Adenomas

Cho

Park

Joo

et al. 2009

J Korean Neurosurg Soc

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Objective : In recent years, CyberKnife has emerged as an important treatment modality in the management of pituitary adenomas. Treatment results after performing CyberKnife and the complications of this procedure are reviewed. Methods : Twenty-six patients with pituitary adenomas received stereotactic radiosurgery with the CyberKnife (CKRS). The follow-up periods ranged from 7 months to 47 months (mean±SD : 30±12.7 months). The patients consisted of 17 with non-functioning adenomas, 3 with prolactinomas and 6 with acromegaly. The change in the tumor volume, visual acuity, hormonal function, and complications by this therapy were analyzed in each case. Results : The tumor control rate was 92.3%. Hormonal function was improved in all of the 9 (100%) functioning adenomas. Hormonal normalization was observed in 4 of the 9 (44%) patients with a mean duration of 16 months. In two patients (7.6%), visual acuity worsened due to cystic enlargement of the tumor after CKRS. No other complications were observed. Conclusion : CyberKnife is considered safe and effective in selected patients with pituitary adenomas. However, longer follow-up is required for a more complete assessment of late toxicity and treatment efficacy.

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Risk of injury to cranial nerves after gamma knife radiosurgery for skull base meningiomas: experience in 88 patients

Cited by 311 publications

References 18 publications

Long-Term Experience of Gamma Knife Radiosurgery for Benign Skull Base Meningiomas

Long-Term Experience of Gamma Knife Radiosurgery for Benign Skull Base Meningiomas

Fractionated Stereotactic Radiotherapy Treatment of Cavernous Sinus Meningiomas: A Study of 100 Cases

Stereotactic Radiosurgery with the CyberKnife for Pituitary Adenomas

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