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Gamma Knife Radiosurgery of Brainstem Cavernous Malformations
Rabih Aboukais1, Laurent Estrade, Patrick Devos
1Department of Neurosurgery, Lille University Hospital, CHU Lille, Université de Lille, Lille, France.
Stereotactic and Functional Neurosurgery
|December 20, 2016
Summary
Gamma Knife radiosurgery (GKS) significantly reduces the annual hemorrhage rate in patients with brainstem cavernous malformations (CMs). GKS is recommended for high-risk surgical cases, with potential for lower radiation doses.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Neurology
Background:
- Hemorrhagic brainstem cavernous malformations (CMs) pose significant clinical challenges.
- Gamma Knife radiosurgery (GKS) is an alternative treatment option for these lesions, particularly when surgery is high-risk.
Purpose of the Study:
- To evaluate the efficacy and safety of Gamma Knife radiosurgery (GKS) for treating brainstem cavernous malformations (CMs).
- To assess the impact of GKS on the annual hemorrhage rate (AHR) in patients with brainstem CMs.
Main Methods:
- Retrospective analysis of 19 patients treated with GKS for brainstem CMs between 2007 and 2012.
- Mean radiation dose of 14.8 Gy and mean target volume of 0.282 cm³.
- Clinical and serial MRI follow-up for a mean of 51.2 months.
Main Results:
- A significant reduction in the annual hemorrhage rate (AHR) was observed post-GKS (from 27.31% to 2.46%, p < 0.001).
- The reduction in AHR was sustained beyond the initial 2-year follow-up period.
- No major morbidity was reported in the context of GKS treatment.
Conclusions:
- GKS is an effective treatment for brainstem CMs, especially in patients with high surgical risk.
- Consideration of lower radiation doses in future GKS treatments for brainstem CMs may be warranted based on comparative literature.
