Stereotactic LINAC radiosurgery for the treatment of brainstem cavernomas

Fuetsch, Manuel; Majdoub, Faycal El; Hoevels, Mauritius; Müller, Rolf-Peter; Sturm, Volker; Maarouf, Mohammad

doi:10.1007/s00066-011-0050-7

Cited by 21 publications

(10 citation statements)

References 53 publications

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“…SRS, implemented by Leksell has now become an additional tool [3]. SRS can be delivered modern linear accelerators with stereotactic tools [4–7]. This study focuses on the results of long-term outcomes with respect to the feasibility, safety and effectiveness of SRS for VS.…”

Section: Introductionmentioning

confidence: 99%

Results for local control and functional outcome after linac-based image-guided stereotactic radiosurgery in 190 patients with vestibular schwannoma

Badakhshi¹,

Graf²,

Böhmer³

et al. 2013

Journal of Radiation Research

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BackgroundWe assessed local control (LC) and functional outcome after linac-based stereotactic radiosurgery (SRS) for vestibular schwannoma (VS). Methods Between 1998 and 2008, 190 patients with VS were treated with SRS. All patients had tumors <2 cm diameter. Patients received 13.5 Gy prescribed to the 80th isodose at the tumor margin. The primary endpoint was LC. Secondary endpoints were symptomatic control and morbidity. Results Median follow-up was 40 months. LC was achieved in 88% of patients. There were no acute reactions exceeding Grade I. Trigeminal nerve dysfunction was present in 21.6% (n = 41) prior to SRS. After treatment, 85% (n = 155) had no change, 4.4,% (n = 8) had a relief of symptoms, 10.4% (n = 19) had new symptoms. Facial nerve dysfunction was present in some patients prior to treatment, e.g. paresis (12.6%; n = 24) and dysgeusia (0.5%; n = 1). After treatment 1.1% (n = 2) reported improvement and 6.1% (n = 11) experienced new symptoms. Hearing problems before SRS were present in 69.5% of patients (n = 132). After treatment, 62.6% (n = 144) had no change, 10.4% (n = 19) experienced improvement and 26.9% (n = 49) became hearing impaired. Conclusion This series of SRS for small VS provided similar LC rates to microsurgery; thus, it is effective as a non-invasive, image-guided procedure. The functional outcomes observed indicate the safety and effectiveness of linac-based SRS. Patients may now be informed of the clinical equivalence of SRS to microsurgery.

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Section: Introductionmentioning

confidence: 99%

Results for local control and functional outcome after linac-based image-guided stereotactic radiosurgery in 190 patients with vestibular schwannoma

Badakhshi¹,

Graf²,

Böhmer³

et al. 2013

Journal of Radiation Research

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“…[10][11][12][13] Despite the administration of similar doses, it is reported that the likelihood of sideeffects is higher than those in patients who underwent SRS due to arterial-vascular malformations (AVM). [11][12][13][14] Another potential disadvantage is that the bleeding risk does not disappear until vascular obliteration occurs. Also, a close clinical follow-up is necessary since it is not possible to reveal complete obliteration by angiography.…”

Section: Discussionmentioning

confidence: 99%

“…Certain recent studies have suggested an early application of SRS due to a possible bleeding risk. [6,14] This recommendation is valid in cases with technically unreachable cavernomas who are more likely to have a risk of death due to recurrent bleeding than those due to SRS. In addition to the decrease in the bleeding risk after SRS, a decrease in the seizure frequency has been reported.…”

Section: Discussionmentioning

confidence: 99%

Stereotactic Radiosurgery in Brain Cavernomas: Single Center Experience

Yaprak¹

2019

South Clin Ist Euras

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In this study, we aimed to present our treatment results involving patients with intracranial cavernomas who were treated with stereotactic radiosurgery (SRS) by using a CyberKnife ®. Methods: Between April 2010 and December 2017, data from 19 patients treated with SRS in our clinic with the diagnosis of cavernomas were retrospectively evaluated. Results: The median follow-up time was 82 months (range: 9-100 months). SRS was performed in the median 1 fraction (range: 1-3); according to the lesion size, the prescription dose ranged from 12 to 21 Gy (median: 15 Gy). During the post-SRS follow-up period, 6 out of the 10 patients with a headache had a complete response, 3 patients had a partial response, and 1 patient had no response. Further, 3 out of the 4 patients with a seizure had a partial response and 1 patient had a stable response in seizure frequency. Furthermore, 1 out of the 2 patients with a vision problem had a complete response and 1 had no change. Also, 1 out of the 3 patients with hemiparesthesia had a complete response and 2 had no change. Radiological evaluations in the post-SRS follow-up period revealed a complete response in 4 patients, partial response in 3 patients, stable disease in 9 patients, and progression in 3 patients. Rebleeding was detected in 1 (5.3%) out of 3 progressive patients at the 17 th month, and radiation-induced radionecrosis was detected in the other 2 patients at the 9 th and 11 th months. There were no procedure-related complications resulting in mortality. Conclusion: In cavernoma patients with a high risk for surgical intervention and/or patients with high risk for bleeding, SRS is an effective and alternative treatment to surgery.

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“…Prior to these two studies, several studies using linear accelerator-based radiosurgery or Gamma-Knife radiosurgery had been reported (17)(18)(19)(20)(21)(22). Most of these studies reported results regarding the rate of bleeding within 2 years after radiosurgery.…”

Section: Discussionmentioning

confidence: 99%