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Stereotactic Radiosurgery for Gynecologic Cancer
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Gamma Knife Radiosurgery for Hemorrhagic Brainstem Cavernomas.

Aysegul Ucuncu Kefeli1, Meric Sengoz, Selcuk Peker

  • 1Kocaeli State Hospital, Radiation Oncology Clinic, Izmit, Turkey.

Turkish Neurosurgery
|January 27, 2018
PubMed
Summary

Gamma Knife Radiosurgery (GKRS) effectively reduced re-bleeding in patients with brainstem cavernous malformations (BSCMs). This treatment offers a safe option for symptomatic BSCMs, significantly lowering hemorrhage risk.

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Area of Science:

  • Neurosurgery
  • Radiation Oncology
  • Vascular Neurology

Background:

  • Hemorrhagic brainstem cavernous malformations (BSCMs) pose significant risks due to their location.
  • Previous treatment options for BSCMs have limitations, necessitating effective interventions.

Purpose of the Study:

  • To evaluate the efficacy and safety of Gamma Knife Radiosurgery (GKRS) for treating hemorrhagic BSCMs.
  • To assess the impact of GKRS on hemorrhage rates in patients with BSCMs.

Main Methods:

  • Retrospective review of 82 patients with hemorrhagic BSCMs treated with GKRS.
  • Analysis of pre- and post-treatment hemorrhage rates and re-bleeding events.
  • Median target volume of 0.3 ml and median marginal radiation dose of 12 Gy were utilized.

Main Results:

  • The pre-treatment annual hemorrhage rate was 55.7%, decreasing to 8.6% after excluding the first bleed.
  • Only three patients experienced re-bleeding post-GKRS, resulting in a low annual re-bleeding rate of 0.87%.
  • GKRS demonstrated a significant reduction in the risk of BSCM hemorrhage.

Conclusions:

  • Gamma Knife Radiosurgery (GKRS) is a safe and effective treatment for symptomatic, low-volume BSCMs, particularly when using a low marginal dose.
  • Further randomized controlled trials are warranted to definitively establish the efficacy of GKRS compared to observation for BSCMs.