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Long-term
Results after Radiosurgery for Benign Intracranial Tumors
Douglas Kondziolka, M.D.;
Narendra Nathoo, M.D.; John C. Flickinger, M.D.; Ajay Niranjan, M.Ch.; Ann H.
Maitz, M.S.; L. Dade Lunsford, M.D.
Departments
of Neurological Surgery and Radiation Oncology, University of Pittsburgh
School of Medicine, Pittsburgh, Pennsylvania
Background.
Stereotactic radiosurgery is the principal therapeutic
alternative to resecting benign intracranial tumors.
The goals of radiosurgery are the long-term prevention of tumor growth,
the maintenance of patient function, and the prevention of new
neurological deficits or adverse radiation effects.
Evaluation of long-term outcomes more than 10 years after
radiosurgery is needed.
Methods. We evaluated 285 consecutive patients who
underwent radiosurgery for benign intracranial tumors between 1987
and 1992.
Serial imaging studies were obtained, and clinical evaluations
were performed.
Our series included 157 patients with vestibular schwannomas, 85
patients with meningiomas, 28 patients with pituitary adenomas, 10
patients with other cranial nerve schwannomas, and 5 patients
with craniopharyngiomas.
Prior surgical resection had been performed in 44% of these
patients, and prior radiotherapy had been administered in 5%.
The median follow-up period was 10 years.
Results. Overall, 95% of the 285 patients in this
series had imaging-defined local tumor control (63% had tumor
regression, and 32% had no further tumor growth).
The actuarial tumor control rate at 15 years was 93.7%.
In 5% of the patients, delayed tumor growth was identified.
Resection was performed after radiosurgery in 13 patients
(5%).
No patient developed a radiation-induced tumor.
Eighty-one percent of the patients were still alive at the time
of this analysis.
Normal facial nerve function was maintained in 95% of
patients who had normal function before undergoing treatment for
acoustic neuromas.
Conclusion. Stereotactic radiosurgery provided high rates
of tumor growth control, often with tumor regression, and low
morbidity rates in patients with benign intracranial tumors
when evaluated over the long term.
This study supports radiosurgery as a reliable alternative to
surgical resection for selected patients with benign intracranial
tumors.
(Neurosurgery 53: 1, 2003)
Key words: Acoustic neuroma, Gamma knife,
Meningioma, Radiosurgery, Schwannoma
Copyright
© by the Congress of Neurological Surgeons
Source: http://www.neurosurgery-online.com/abstracts/5304/NURO53040001_abstx.html
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