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Multisession Gamma Knife surgery for benign orbital tumors
Kyung-Il Jo1, Yong Seok Im, Doo-Sik Kong
1Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Journal of Neurosurgery
|December 5, 2012
Summary
Multisession Gamma Knife surgery (GKS) is safe and effective for benign orbital tumors near the optic nerve. This treatment achieved tumor control and preserved or improved vision in all patients, with no adverse events.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Ophthalmology
Background:
- Benign orbital tumors pose treatment challenges, especially when adjacent to critical structures like the optic nerve.
- Preserving visual function is paramount in managing these tumors.
Purpose of the Study:
- To evaluate the safety and efficacy of multisession Gamma Knife surgery (GKS) for benign orbital tumors.
- To assess tumor control and visual outcomes following GKS in patients with tumors touching the optic nerve.
Main Methods:
- A cohort of 23 patients with benign orbital tumors adjacent to the optic nerve, who maintained vision, underwent multisession (4-fraction) GKS.
- The median tumor volume was 2800 mm³, with a median cumulative margin dose of 20 Gy (range 18-22 Gy).
Main Results:
- No tumor progression was observed during a median follow-up of 38 months.
- Tumor shrinkage was more pronounced in cavernous hemangiomas (p < 0.05).
- All 23 patients maintained or improved their visual acuity and/or visual field, with no reported adverse events related to GKS.
Conclusions:
- Multisession GKS is a viable strategy for treating benign orbital tumors in direct contact with the optic nerve.
- A cumulative margin dose of up to 22 Gy in 4 fractions is safe, ensuring visual function preservation and high tumor control rates.
