Long Term Follow-up Results of External Beam Radiotherapy as Primary Treatment for Retinoblastoma

Results for treating glomus jugulare tumors with radiosurgery have been limited by short follow-up and small number of patients. We report our experience using LINAC or CyberKnife in 21 tumors with a median follow-up of 66 months (Mean follow-up of 60 months). In addition, we have a subset of eight patients that were followed out for more than 10 years. Patients were treated with doses ranging from 1400 cGy to 2700 cGy. We retrospectively assessed patients for efficacy and post treatment side effects. All patients had stable neurological symptoms, and two patients experienced transient ipsilateral tongue weakness and hearing loss, both of which subsequently resolved. One patient experienced transient ipsilateral vocal cord paresis; however, this patient received previous external beam radiotherapy. All tumors remained stable or decreased in size by MRI exam. Our results support radiosurgery as an effective and safe method of treatment for glomus jugulare tumors with low morbidity as evidenced by a larger number of patients and long term follow-up.

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Percutaneous Drainage of Hydatid Cyst in the Liver as a Primary Treatment: Review of 52 Consecutive Cases with Long-term Follow-up

Clinical Radiology ◽

10.1053/crad.2000.0543 ◽

2000 ◽

Vol 55 (11) ◽

pp. 839-848 ◽

Cited By ~ 26

Author(s):

ZELJKO B BOSANAC ◽

LJUBOMIR LISANIN

Keyword(s):

Hydatid Cyst ◽

Percutaneous Drainage ◽

Primary Treatment ◽

Treatment Review ◽

Long Term Follow Up

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Delayed Cerebrovascular Complications of Intrathecal Colloidal Gold

Neurosurgery ◽

10.1097/00006123-200112000-00004 ◽

2001 ◽

Vol 49 (6) ◽

pp. 1308-1312 ◽

Cited By ~ 6

Author(s):

Eric S. Nussbaum ◽

Leslie A. Sebring ◽

Joseph P. Neglia ◽

Ray Chu ◽

Nancy D. Mattsen ◽

...

Keyword(s):

Colloidal Gold ◽

Aneurysmal Subarachnoid Hemorrhage ◽

External Beam Radiotherapy ◽

University Of Minnesota ◽

Gold Therapy ◽

Term Survival ◽

Cerebrovascular Complications ◽

Long Term Follow Up

ABSTRACT OBJECTIVE Therapy with intrathecal colloidal gold has been used in the past as an adjunct in the treatment of childhood neoplasms, including medulloblastoma and leukemia. We describe the long-term follow-up period of a series of patients treated with intrathecal colloidal gold and emphasize the high incidence of delayed cerebrovascular complications and their management. METHODS Between 1967 and 1970, 14 children with posterior fossa medulloblastoma underwent treatment at the University of Minnesota. Treatment consisted of surgical resection, external beam radiotherapy, and intrathecal colloidal gold. All patients underwent long-term follow-up periods. RESULTS Of the 14 original patients, 6 died within 2 years of treatment; all experienced persistent or recurrent disease. The eight surviving patients developed significant neurovascular complications 5 to 20 years after treatment. Three patients died as a result of aneurysmal subarachnoid hemorrhage, and five developed ischemic symptoms from severe vasculopathy that resembled moyamoya disease. CONCLUSION Although therapy with colloidal gold resulted in long-term survival in a number of cases of childhood medulloblastoma, our experience suggests that the severe cerebrovascular side effects fail to justify its use. The unique complications associated with colloidal gold therapy, as well as the management of these complications, are presented. We recommend routine screening of any long-term survivors to exclude the presence of an intracranial aneurysm and to document the possibility of moyamoya syndrome.

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Megavoltage pituitary irradiation lowers but seldom leads to safe GH levels in acromegaly: a long-term follow-up study

Acta Endocrinologica ◽

10.1530/eje.0.1380160 ◽

1998 ◽

pp. 160-163 ◽

Cited By ~ 27

Author(s):

NC Thalassinos ◽

S Tsagarakis ◽

G Ioannides ◽

I Tzavara ◽

C Papavasiliou

Keyword(s):

Additional Data ◽

External Beam ◽

Follow Up Study ◽

Long Term Follow Up ◽

Biochemical Cure ◽

Definition Of ◽

Pituitary Irradiation ◽

Tsh Deficiency

Radiotherapy (RT) has long been used in the treatment of acromegaly, but confusion regarding the definition of biochemical cure has hampered interpretation of previous reports on the outcome of this treatment. In the present study we present additional data using the currently accepted criteria of biochemical cure in a large group of patients followed up by our department. Forty-six acromegalic patients were treated with external beam megavoltage RT and followed up for a mean of 7.6 years (range 2-22 years). Only four patients had had previous surgical treatment by either transsphenoidal or transfrontal routes. Following RT, mean basal GH levels decreased from 30.9 ng/ml (5-96 ng/ml) to 11.5 ng/ml (1-36 ng/ml) at 10 years of follow up with a further fall to 6.1 ng/ml (1-29 ng/ml) in those patients followed up for more than 10 years. As a result, although mean GH levels of less than 5 ng/ml were achieved in 9/28 (30.1%) at 5 years, 6/19 (31.6%) at 10 years, and in 6/11 (54.5%) of those patients followed up for more than 10 years post-RT, only 0/28 (0%), 7/28 (25%), 4/19 (21%) and 1/11 (1%) achieved GH levels of <2.5 ng/ml at 2, 5. 10 and >10 years following RT. Thus, in the whole series only 10/48 (20.8%) patients showed a decrease of GH level to less than 2.5 ng/ml at their latest follow up. Hypopituitarism as a result of RT was only infrequently observed in this series; gonadal deficiency developed in 12 (26.6%) patients, thyrotrophin (TSH) deficiency in 3 (6.6%) and adrenocorticotrophin deficiency in 2 (4.4%). In conclusion, megavoltage RT is an effective treatment for the control of GH hypersecretion in acromegaly, with a continuing lowering effect for several years following RT but seldom leads to safe GH levels.

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