Planned Subtotal Resection in Benign Skull Base Tumors Followed by Gamma Knife Surgery: Preliminary Results

Object The object of this study was to compare the recurrence rates of cystic craniopharyngiomas after neuroendoscopic cyst fenestration combined with Gamma Knife surgery (GKS) and after subtotal resection (STR) combined with GKS. Methods The records of 27 patients (age range 3–66 years) with cystic craniopharyngiomas that were treated surgically or neuroendoscopically before GKS between January 2000 and December 2007 were reviewed to compare recurrence rates. The patients were divided into 2 groups: Group 1 (13 patients) received the neuroendoscopic procedure before GKS, and Group 2 (14 patients) received an STR followed by GKS. Tumor volumes, radiation doses, visual field defects, endocrine levels, and recurrences were compared between the 2 groups. Patients with solid tumors and those who underwent complete resection were excluded from the study. Results The recurrence rate for Group 1 was higher than that of Group 2 (p = 0.046). The radiation dose near the optic chiasm was higher in Group 1 (p = 0.021) than in Group 2. However, endocrine function was better preserved in Group 1 than in Group 2. Conclusions This investigation confirms that STR followed by GKS results in a lower recurrence rate than neuroendoscopy and GKS. Neuroendoscopy and GKS, however, results in a better preservation of endocrine function. These results suggest that a generalized multimodal approach including endoscopic fenestration in addition to GKS is hindered by higher recurrence rates.

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Gamma-knife radiosurgery in pediatric cerebral and skull base tumors

Medical and Pediatric Oncology ◽

10.1002/mpo.10218 ◽

2002 ◽

Vol 40 (2) ◽

pp. 99-103 ◽

Cited By ~ 8

Author(s):

Asle Hirth ◽

Paal-Henning Pedersen ◽

Roald Baardsen ◽

John Ludvig Larsen ◽

B�rd K. Krossnes ◽

...

Keyword(s):

Skull Base ◽

Gamma Knife ◽

Gamma Knife Radiosurgery ◽

Skull Base Tumors

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Volume-staged gamma knife surgery for the treatment of large skull base meningioma surrounding the optical apparatus: A snowman-shape design

Journal of the Chinese Medical Association ◽

10.1016/j.jcma.2017.03.011 ◽

2017 ◽

Vol 80 (11) ◽

pp. 697-704 ◽

Cited By ~ 2

Author(s):

Chain-Fa Su ◽

Dai-Wei Liu ◽

Cheng-Chia Lee ◽

Tsung-Lang Chiu

Keyword(s):

Skull Base ◽

Gamma Knife ◽

Gamma Knife Surgery ◽

Shape Design ◽

Skull Base Meningioma

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Gamma Knife surgery for skull base chordomas and chondrosarcomas

Journal of Neurosurgery ◽

10.3171/jns-07/10/0752 ◽

2007 ◽

Vol 107 (4) ◽

pp. 752-757 ◽

Cited By ~ 69

Author(s):

Toshinori Hasegawa ◽

Dai Ishii ◽

Yoshihisa Kida ◽

Masayuki Yoshimoto ◽

Joji Koike ◽

...

Keyword(s):

Skull Base ◽

Gamma Knife ◽

Tumor Volume ◽

Tumor Resection ◽

Gamma Knife Surgery ◽

High Rate ◽

Tumor Control ◽

Low Grade ◽

The Mean ◽

Skull Base Chordomas

Object The purpose of this study was to evaluate radiosurgical outcomes in skull base chordomas and chondrosarcomas, and to determine which tumors are appropriate for stereotactic radiosurgery as adjuvant therapy following maximum tumor resection. Methods Thirty-seven patients (48 lesions) were treated using Gamma Knife surgery (GKS); 27 had chordomas, seven had chondrosarcomas, and three had radiologically diagnosed chordomas. The mean tumor volume was 20 ml, and the mean maximum and marginal doses were 28 and 14 Gy, respectively. The mean follow-up period was 97 months from diagnosis and 59 months from GKS. Results The actuarial 5- and 10-year survival rates after GKS were 80 and 53%, respectively. The actuarial 5- and 10-year local tumor control (LTC) rates after single or multiple GKS sessions were 76 and 67%, respectively. All patients with low-grade chondrosarcomas achieved good LTC. A tumor volume of less than 20 ml significantly affected the high rate of LTC (p = 0.0182). No patient had adverse radiation effects, other than one in whom facial numbness worsened despite successful tumor control. Conclusions As an adjuvant treatment after resection, GKS is a reasonable option for selected patients harboring skull base chordomas or chondrosarcomas with a residual tumor volume of less than 20 ml. Dose planning with a generous treatment volume to avoid marginal treatment failure should be made at a marginal dose of at least 15 Gy to achieve long-term tumor control.

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Usefulness of the Advanced Neuroimaging Protocol Based on Plain and Gadolinium-Enhanced Constructive Interference in Steady State Images for Gamma Knife Radiosurgery and Planning Microsurgical Procedures for Skull Base Tumors

Gamma Knife Neurosurgery in the Management of Intracranial Disorders ◽

10.1007/978-3-7091-1376-9_26 ◽

2012 ◽

pp. 167-178 ◽

Cited By ~ 2

Author(s):

Motohiro Hayashi ◽

Mikhail F. Chernov ◽

Noriko Tamura ◽

Shoji Yomo ◽

Manabu Tamura ◽

...

Keyword(s):

Steady State ◽

Skull Base ◽

Gamma Knife ◽

Gamma Knife Radiosurgery ◽

Skull Base Tumors ◽

Constructive Interference

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Skull base approaches and gamma knife radiosurgery for multimodality treatment of skull base tumors

Journal of Neurosurgery ◽

10.3171/jns.2002.97.supplement_5.0674 ◽

2002 ◽

Vol 97 ◽

pp. 674-676 ◽

Cited By ~ 6

Author(s):

Paul C. Francel ◽

Sumon Bhattacharjee ◽

Paul Tompkins

Keyword(s):

Radiation Dose ◽

Skull Base ◽

Gamma Knife ◽

Gamma Knife Radiosurgery ◽

Multimodality Treatment ◽

Skull Base Tumor ◽

Skull Base Tumors ◽

Content Type ◽

Fine Print

Object. The purpose of this study was to evaluate descriptive data obtained in patients who had received multimodality treatment with resection and gamma knife radiosurgery (GKS) for skull base tumors. Retrospective data were collected from 71 patients with skull base tumors who were treated from November 1996 to December 2000, all of whom underwent follow-up evaluation at 1 year or more. Methods. Data were collected from hospital charts and office records, including patient age, tumor type and location, number of tumors, maximum radiation dose, estimated radiation dose to the periphery, tumor volume, and percentage of patients with tumors smaller or the same size at follow-up evaluation. Conclusions. Of the 71 patients with 1 year or more of follow up, 93% had tumor either the same size or smaller and 34% of these patients had a smaller tumor size. It is concluded that: 1) GKS with multimodality treatment is effective for control of skull base tumors; 2) the radiosurgical team should consider the benefits of GKS for treatment of any skull base tumor to afford optimum patient management; and 3) neurosurgeons involved with the management of skull base tumors should either be trained and proficient in GKS or work closely with a colleague trained in the technique. This will ensure proper consideration of both options, resulting in overall improved patient treatment.

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