Safety and Efficacy of Multisession Gamma Knife Radiosurgery for (Large Benign Intracranial Lesions > 3cm)

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Published: Oct 4, 2024
DOI: https://doi.org/10.47191/ijpbms/v4-i10-02
Keywords:
Key words: Gamma knife , stereotactic radiosurgery ,multisession , gray ,volume staged.

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Sarah Zuhair
M.B.Ch.B, F.I.C.M (neurosurgery), Lecturer/neurosurgeon at Al- Kufa university-college of medicine, Al-Sader medical city, Najaf, Iraq
Yasir Mohammed Hasan Hamandi
M.B.Ch.B/F.I.C.M.S (neurosurgery), Professor/consultant Neurosurgeon, Gamma knife department at Saad Al wittry Neuroscience Hospital & Al-Nahrain university-college of medicine, Baghdad, Iraq

Abstract

Background: Stereotactic radiosurgery is delivery of an ablative dose of ionizing radiation to a focused target with 3D localization to elicit a specific radiobiological response and sparing the surrounding normal brain tissue.


Objective: to evaluate safety and efficacy of Gamma knife radiosurgery by volume staging of large benign intracranial lesions.


Patients and methods: prospective cohort study is conducted at Saad Alwitry neuroscience hospital, gamma knife department between June 2017 to February 2021, 60 patients (25 case meningioma ,15 case vestibular schwannoma ,10 case arteriovenous malformation and 10 patients with pituitary macro-adenoma) having large lesions of >3cm were treated by multisession radiosurgery (2-3 sessions), time between sessions (24hr-6m), follow up time ranged from(6ms-3yr).


Results: rate of growth control for meningioma, vestibular schawannoma, AVM and pituitary macro-adenoma was 76 %,53.3% ,30% and 60% while reduction in lesion size is 20%, 33.3%, 70% and 30% respectively and clinical improvement was 86.4% for meningioma ,52.6% for VS ,73.2% for AVM and 88% for PA and the complications reported were 15.2%.


Conclusion: volume staged multisession GKSR is effective, safe and well tolerated with low morbidity modality for these large lesions.

Article Details

How to Cite
Zuhair, S., & Yasir Mohammed Hasan Hamandi. (2024). Safety and Efficacy of Multisession Gamma Knife Radiosurgery for (Large Benign Intracranial Lesions > 3cm). International Journal of Pharmaceutical and Bio Medical Science, 4(10), 776–788. https://doi.org/10.47191/ijpbms/v4-i10-02
Issue
Vol. 4 No. 10 (2024): Volume 04 Issue 10 October 2024
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Articles
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This work is licensed under a Creative Commons Attribution 4.0 International License.

References

I. Ganz C.J ; Introduction and the Nature of Radiosurgery, Gamma Knife Neurosurgery,3rd ed, NewYork: Springer 2011.chap 1 ,p(27-28).

II. Minniti G. and Scaringi C. ; Fractionated Radiosurgery , Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy,1st ed, Springer 2019, p (94-97).

III. Rashid A. , Memon A. M. Ahmed U. ,et al , Multisession stereotactic radiosurgery for large benign brain tumors of >3cm- early clinical outcomes , Journal of Radiosurgery and SBRT, , April 19, 2012 ; Vol. 2, p (29-40).

IV. Flickinger C. J. ; The Radiobiology of Radiosurgery , Intracranial Stereotactic Radiosurgery, 2nd ed, Thieme 2016 , p (38-45).

V. Iwai Y, Yamanaka K, Shimohonji W, Ishibashi K. Staged gamma knife radiosurgery for large skull base meningiomas. Cureus. 2019 Oct; vol 11 ,p (10).

VI. Kano H, Kondziolka D, Flickinger JC, Park KJ, Parry PV, Yang HC, Sirin S, Niranjan A, Novotny J, Lunsford LD. Stereotactic radiosurgery for arteriovenous malformations, Part 6: multistaged volumetric management of large arteriovenous malformations. Journal of neurosurgery. 2012 Jan ; vol 116(1) : p (54-65).

VII. Pollock BE, Link MJ, Stafford SL, Garces YI, Foote RL. Stereotactic radiosurgery for arteriovenous malformations: the effect of treatment period on patient outcomes. Neurosurgery. 2016 Apr ; vol 78(4):p (499-509).

VIII. Hansasuta A., Choi H C., Soltys G.S., et al ; Multisession stereotactic radiosurgery for vestibular schwannomas: single-institution experience with 383 cases, Neurosurgery, 2011 Dec, Vol 69(6), P(1200–1209).

IX. albano l. , Losa M. , Nadin F. ,et al; Safety and efficacy of multisession gamma knife radiosurgery for residual or recurrent pituitary adenomas , Endocrine ,springer, Feb 2019, vol 64(23), p (639–647).

X. McTyre E, Helis CA, Farris M and et al; Emerging indications for fractionated gamma knife radiosurgery. Neurosurgery. 2017 Feb ; vol 80(2): p(210-216).

XI. Albano L, Losa M, Nadin F and et al ; Safety and efficacy of multisession gamma knife radiosurgery for residual or recurrent pituitary adenomas, Endocrine. 2019 Jun; vol 64(3) ,p(639-647).

XII. Casentini L, Fornezza U, Perini Z, Perissinotto E, Colombo F. Multisession stereotactic radiosurgery for large vestibular schwannomas. Journal of neurosurgery. 2015 Apr; vol 122(4) , p (818-824).

XIII. Ilyas A, Chen CJ, Ding D, Taylor DG, Moosa S, Lee CC, : Volume-staged versus dose-staged stereotactic radiosurgery outcomes for large brain arteriovenous malformations: a systematic review. J Neurosurgy , 2018 Dec , vol 128 , p(154–164).

XIV. Kirkpatrick JP., Soltys SG. ; The radiosurgery fractionation quandary: single fraction or hypofractionation , Neuro-Oncology. 2017, vol 19: p (938–949).

XV. Jiang B., Hara W. and Li F. G. ; Role of Radiosurgery for Sellar Lesions, Handbook of Radiosurgery in CNS Disease, 1st ed, DEMOSMedical 2013, p (120-126).

XVI. Lee C., Trifiletti M D. and Sheehan P. J. ; Stereotactic Radiosurgery for Pituitary Adenoma, Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy, 1st ed, Springer 2019 , p (121-128).

XVII. albano l. , Losa M. , Nadin F. ,et al; Safety and efficacy of multisession gamma knife radiosurgery for residual or recurrent pituitary adenomas , Endocrine ,springer, Feb 2019, vol 64(23), p (639–647).

XVIII. McTyre E, Helis CA, Farris M, et al ;Emerging indications for fractionated gamma knife Radiosurgery. Neurosurgery. 2017 Feb ; vol 80(2), p(210-216).

XIX. Nguyen JH, Chen CJ, Lee CC, Yen CP, Xu Z, Schlesinger D, Sheehan JP. Multisession gamma knife radiosurgery: a preliminary experience with a noninvasive, relocatable frame. World neurosurgery. 2014 Dec; vol 82(6): p (1256-1263).

XX. 20. Flemming D.K. and Brown D.R. ; Epidemiology and Natural History of Intracranial Vascular Malformations, Youmans and Winn neurological surgery, 7th ed, Elsevier 2017, p(5512-5515).

XXI. Choudhri O., Chang D. S. , and Steinberg K.G. ; Surgical and radiosurgical Management of Grade IV and V Arteriovenous Malformations , Youmans and Winn neurological surgery, 7th ed, Elsevier 2017,p (5593-5607).