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Radiosurgery for symptomatic cavernous malformations: A multi-institutional retrospective study in Japan
Yoshihisa Kida1, Toshinori Hasegawa2, Yoshiyasu Iwai3
1Department of Neurosurgery, General Kamiiida Daiichi Hospital, Scientific Committee of Japanese Gamma Knife Society, Japan.
Surgical Neurology International
|May 26, 2015
Summary
Gamma Knife (GK) surgery significantly reduces hemorrhage risk in symptomatic cavernous malformation (CM). This radiosurgery offers superior hemorrhage-free survival compared to conservative management for CM patients.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Neurology
Background:
- Symptomatic cavernous malformations (CM) pose significant clinical challenges.
- Gamma Knife (GK) surgery is an established treatment modality for CM.
Purpose of the Study:
- To evaluate the efficacy and safety of GK surgery for symptomatic CM.
- To identify factors influencing treatment outcomes and complications.
Main Methods:
- A multi-center study involving 298 patients with symptomatic CM treated with GK surgery.
- Data collected from 23 GK centers across Japan.
- Analysis of hemorrhage, seizures, neurological deficits, lesion location, diameter, and GK dosage.
Main Results:
- Hemorrhage-free survival (HFS) showed a dissociation between hemorrhage and seizure groups.
- Superficial CMs responded better than deep-seated lesions.
- Complications increased with marginal doses over 15 Gy and lesion diameters >15 mm.
- Overall hemorrhage rate post-GK was 4.4%/year/patient.
Conclusions:
- GK surgery considerably reduces hemorrhage risk in symptomatic CM.
- GK treatment demonstrates superior HFS and reduced annual hemorrhage rates compared to conservative management.
- Minimizing complications is crucial for optimizing GK treatment success.
