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Radiosurgery in lesional epilepsy: brain tumors
O Schröttner1, H G Eder, F Unger
1Department of Neurosurgery, Karl-Franzens University, Graz, Austria. oschroet@kfunigraz.ac.at
Stereotactic and Functional Neurosurgery
|October 23, 1998
Summary
Gamma Knife radiosurgery (GKRS) effectively controls tumors causing epilepsy. Higher radiation doses to surrounding brain tissue correlate with better seizure control outcomes.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Epileptology
Background:
- Medically intractable epilepsy associated with brain tumors poses significant treatment challenges.
- Gamma Knife radiosurgery (GKRS) is a minimally invasive option for tumor-associated epilepsy.
Purpose of the Study:
- To investigate the impact of radiation dose distribution on seizure control in patients with tumor-associated epilepsy treated with GKRS.
- To identify factors influencing treatment outcomes in this patient population.
Main Methods:
- Retrospective analysis of 26 patients with tumor epilepsy treated with GKRS between 1992 and 1995.
- Classification of patients into two groups based on the ratio of irradiated tissue volume (10 Gy or more) to tumor volume (10G/Tum ratio).
- Assessment of seizure control using the Engel classification, with a mean follow-up of 2.25 years.
Main Results:
- Tumor control was achieved in all patients.
- Excellent seizure control (Engel class I or II) was observed in 54% of patients.
- A higher 10G/Tum ratio (Group II, >3) was associated with a higher rate of excellent seizure control (66%) compared to a lower ratio (Group I, ≤3) (42%).
- Temporal lobe tumors and shorter epilepsy duration (≤2.5 years) were also linked to better outcomes.
Conclusions:
- The volume of adjacent brain tissue receiving high-dose radiation is a critical factor in achieving seizure control with GKRS for tumor epilepsy.
- Tumor location and epilepsy duration are important prognostic indicators for GKRS treatment success.