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Related Experiment Videos

Stereotactic radiosurgery: the Lyon experience

F P Rocher1, I Sentenac, C Berger

  • 1Service de Radiothérapie et Oncologie, Centre Hospitalier Lyon-Sud, Pierre Bénite, France.

Acta Neurochirurgica. Supplement
|January 1, 1995
PubMed
Summary

Stereotactic Radiosurgery (RS) showed promising results for AVMs and meningiomas, with significant obliteration and regression rates. However, high visual complication rates led to its discontinuation for most pituitary adenomas.

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Area of Science:

  • Neurosurgery
  • Radiation Oncology
  • Neurology

Background:

  • Stereotactic Radiosurgery (RS) and External Beam Radiotherapy (EBRT) are treatment options for AVMs and tumors.
  • Previous treatments like embolization and surgery may not be curative for all cases.

Purpose of the Study:

  • To evaluate the efficacy and safety of RS +/- EBRT for AVMs, meningiomas, and pituitary adenomas.
  • To assess radiological and clinical outcomes, as well as complication rates.

Main Methods:

  • 135 patients treated between 10/1989 and 12/1992 with RS +/- EBRT.
  • Lesions treated were AVMs or tumors not exceeding 30-35 mm.
  • Doses ranged from 15-20 Gy (70% isodose) in a single course.

Main Results:

Related Experiment Videos

  • For 42 AVMs, one rebleed occurred; 9/15 showed clinical improvement. Radiological follow-up (4-29 months) revealed 10 complete obliterations, 7 >80% regressions, and 6 with 50-80% reduction. Three grade 3 radionecrosis occurred.
  • For 15 meningiomas, 3 progressed (2 controlled by surgery). 4/9 symptomatic patients improved. Radiological follow-up (4-24 months) showed 5 stabilized and 6 regressed. Two grade 3 complications occurred.
  • For 42 pituitary adenomas, RS showed good biological and radiological results, but a high visual complication rate (12/42, 8 grade 3) led to discontinuation for most cases, except small adenomas distant from the optic chiasma.

Conclusions:

  • RS +/- EBRT is effective for AVMs and meningiomas, offering significant lesion reduction and stabilization.
  • High visual complication rates associated with pituitary adenoma treatment necessitate careful patient selection and limit its application.
  • Treatment outcomes are influenced by lesion volume, proximity to critical structures (optic pathways), and pre-existing conditions.