Gamma knife radiosurgery for benign cavernous sinus tumors: Treatment concept and outcomes in 120 cases

Motohiro Hayashi, Mikhail Chernov, Noriko Tamura, Manabu Tamura, Ayako Horiba, Yoshiyuki Konishi, Yoshikazu Okada, Yoshihiro Muragaki, Hiroshi Iseki, Kintomo Takakura

    Research output: Contribution to journalArticle

    10 Citations (Scopus)

    Abstract

    Availability of modern computer-aided robotized devices, such as the Automatic Positioning System (APS™; Elekta Instruments AB, Stockholm, Sweden) and Perfexion™ (Elekta Instruments AB), allowed us to develop the original concept of robotic gamma knife microradiosurgery, which is based on the very precise irradiation of the lesion with regard to conformity and selectivity; intentional avoidance of the excessive irradiation of functionally-important anatomical structures, particularly cranial nerves, located both within and in the vicinity of the target; and delivery of sufficient irradiation energy to the tumor with the intention to attain lesion shrinkage, while keeping the marginal dose sufficiently low for prevention of possible complications. The results of such treatment strategy were evaluated retrospectively in 120 patients with benign cavernous sinus neoplasms (pituitary adenomas, meningiomas, schwannomas, and hemangiomas), who were followed up from 24 to 78 months (mean 47 months) after radiosurgery. Tumor growth control and shrinkage rates were 98% and 68%, respectively. More than 50% volume reduction was noted in 25% of lesions. The most prominent volumetric tumor response was observed in hemangiomas, followed by schwannomas, pituitary adenomas, and meningiomas. Treatment-related complications were marked in 7% of cases, and were mainly related to transient isolated cranial neuropathy appearing within several months after radiosurgery. Major morbidity was limited to one patient (0.8%). Application of microradiosurgical treatment principles provides effective and safe management of benign cavernous sinus tumors and is associated with high probability of lesion shrinkage and minimal risk of complications.

    Original languageEnglish
    Pages (from-to)714-723
    Number of pages10
    JournalNeurologia Medico-Chirurgica
    Volume52
    Issue number10
    DOIs
    Publication statusPublished - 2012 Nov 19

    Keywords

    • Automatic positioning system
    • Cavernous sinus tumor
    • Gamma knife radiosurgery
    • Microradiosurgery
    • Outcome

    ASJC Scopus subject areas

    • Surgery
    • Clinical Neurology

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  • Cite this

    Hayashi, M., Chernov, M., Tamura, N., Tamura, M., Horiba, A., Konishi, Y., Okada, Y., Muragaki, Y., Iseki, H., & Takakura, K. (2012). Gamma knife radiosurgery for benign cavernous sinus tumors: Treatment concept and outcomes in 120 cases. Neurologia Medico-Chirurgica, 52(10), 714-723. https://doi.org/10.2176/nmc.52.714