scholarly journals Gamma Knife Radiosurgery for the Vestibular Schwannomas, Technical Considerations and Hydrocephalus as a Complication

10.5772/30361 ◽  
2011 ◽  
Author(s):  
Sung Kyoo ◽  
Kisoo Park ◽  
Dong Hyun ◽  
Seong Hyun ◽  
Jaechan Park ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Vestibular Schwannomas ◽  
Technical Considerations

scholarly journals Is salvage surgery for large vestibular schwannomas after failed gamma knife radiosurgery more challenging?

2021 ◽  
Author(s):  
Lucas Troude ◽  
Mohamed Boucekine ◽  
Anne Balossier ◽  
Guillaume Baucher ◽  
Jean-Pierre Lavieille ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Salvage Surgery ◽  
Gamma Knife Radiosurgery ◽  
Vestibular Schwannomas

scholarly journals Treating Vestibular Schwannomas with Gamma-Knife Radiosurgery Versus Microsurgery: Long-Term Follow-up of 702 Cases

2019 ◽  
Vol 87 (June) ◽  
pp. 2599-2610
Author(s):  
AHMED R. RIZK, M.D. GUIHERME LEPSLI, M.D. ◽  
GERHARD A. HORSTMANN, M.D. MARCOS TATABIBA, M.D.
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Vestibular Schwannomas ◽  
Long Term Follow Up

Long-term outcomes of Gamma Knife radiosurgery in patients with vestibular schwannomas

2011 ◽  
Vol 114 (2) ◽  
pp. 432-440 ◽  
Author(s):  
Erin S. Murphy ◽  
Gene H. Barnett ◽  
Michael A. Vogelbaum ◽  
Gennady Neyman ◽  
Glen H. J. Stevens ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Vestibular Schwannomas ◽  
Tumor Control ◽  
Tumor Diameter ◽  
Long Term Effects ◽  
Median Dose ◽  
The Mean

Object The authors sought to determine the long-term tumor control and side effects of Gamma Knife radiosurgery (GKRS) in patients with vestibular schwannomas (VS). Methods One hundred seventeen patients with VS underwent GKRS between January 1997 and February 2003. At the time of analysis, at least 5 years had passed since GKRS in all patients. The mean patient age was 60.9 years. The mean maximal tumor diameter was 1.77 ± 0.71 cm. The mean tumor volume was 1.95 ± 2.42 ml. Eighty-two percent of lesions received 1300 cGy and 14% received 1200 cGy. The median dose homogeneity ratio was 1.97 and the median dose conformality ratio was 1.78. Follow-up included MR imaging or CT scanning approximately every 6–12 months. Rates of progression to surgery were calculated using the Kaplan-Meier method. Results Of the 117 patients in whom data were analyzed, 103 had follow-up MR or CT images and 14 patients were lost to follow-up. Fifty-three percent of patients had stable tumors and 37.9% had a radiographically documented response. Imaging-documented tumor progression was present in 8 patients (7.8%), but in 3 of these the lesion eventually stabilized. Only 5 patients required a neurosurgical intervention. The estimated 1-, 3-, and 5-year rates of progression to surgery were 1, 4.6, and 8.9%, respectively. One patient (1%) developed trigeminal neuropathy, 4 patients (5%) developed permanent facial neuropathy, 3 patients (4%) reported vertigo, and 7 patients (18%) had new gait imbalance following GKRS. Conclusions Gamma Knife radiosurgery results in excellent local control rates with minimal toxicity for patients with VS. The authors recommend standardized follow-up to gain a better understanding of the long-term effects of GKRS.

Temporal Dynamics of Pseudoprogression After Gamma Knife Radiosurgery for Vestibular Schwannomas—A Retrospective Volumetric Study

Neurosurgery ◽  
2018 ◽  
Vol 84 (1) ◽  
pp. 123-131 ◽  
Author(s):  
Jonathan D Breshears ◽  
Joseph Chang ◽  
Annette M Molinaro ◽  
Penny K Sneed ◽  
Michael W McDermott ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Temporal Dynamics ◽  
Gamma Knife Radiosurgery ◽  
Vestibular Schwannomas ◽  
Volumetric Study

scholarly journals Gamma Knife radiosurgery for vestibular schwannomas: Evaluation of planning using the sphericity degree of the target volume

PLoS ONE ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. e0225638
Author(s):  
Crystian Wilian Chagas Saraiva ◽  
Simone Coutinho Cardoso ◽  
Daniela Piai Groppo ◽  
Antônio Afonso Ferreira De Salles ◽  
Luiz Fernando de Ávila ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Target Volume ◽  
Vestibular Schwannomas

Gamma Knife radiosurgery for treatment of growing vestibular schwannomas in patients with neurofibromatosis Type 2: a matched cohort study with sporadic vestibular schwannomas

2018 ◽  
Vol 128 (1) ◽  
pp. 49-59 ◽  
Author(s):  
Ivo J. Kruyt ◽  
Jeroen B. Verheul ◽  
Patrick E. J. Hanssens ◽  
Henricus P. M. Kunst
Keyword(s):  
Gamma Knife ◽  
Tumor Volume ◽  
Gamma Knife Radiosurgery ◽  
Neurofibromatosis Type ◽  
Hearing Preservation ◽  
Vestibular Schwannomas ◽  
Tumor Control ◽  
Nerve Function

OBJECTIVENeurofibromatosis Type 2 (NF2) is a tumor syndrome characterized by an autosomal dominant pattern of inheritance. The hallmark of NF2 is the development of bilateral vestibular schwannomas (VSs), generally by 30 years of age. One of the first-line treatment options for small to medium-large VSs is radiosurgery. Although radiosurgery shows excellent results in sporadic VS, its use in NF2-related VS is still a topic of dispute. The aim of this study was to evaluate long-term tumor control, hearing preservation rates, and factors influencing outcome of optimally dosed, contemporary Gamma Knife radiosurgery (GKRS) for growing VSs in patients with NF2 and compare the findings to data obtained in patients with sporadic VS also treated by means of GKRS.METHODSThe authors performed a retrospective analysis of 47 growing VSs in 34 NF2 patients who underwent GKRS treatment performed with either the Model C or Perfexion Leksell Gamma Knife, with a median margin dose of 11 Gy. Actuarial tumor control rates were estimated using the Kaplan-Meier method. For patient- and treatment-related factors, a Cox proportional hazards model was used to identify predictors of outcome. Trigeminal, facial, and vestibulocochlear nerve function were assessed before and after treatment. NF2-related VS patients were matched 1:1 with sporadic VS patients who were treated in the same institute, and the same indications for treatment, definitions, and dosimetry were used in order to compare outcomes.RESULTSActuarial tumor control rates in NF2 patients after 1, 3, 5, and 8 years were 98%, 89%, 87%, and 87%, respectively. Phenotype and tumor volume had significant hazard rates of 0.086 and 22.99, respectively, showing that Feiling-Gardner phenotype and a tumor volume not exceeding 6 cm3 both were associated with significantly better outcome. Actuarial rates of serviceable hearing preservation after 1, 3, 5, and 7 years were 95%, 82%, 59%, and 33%, respectively. None of the patients experienced worsening of trigeminal nerve function. Facial nerve function worsened in 1 patient (2.5%). No significant differences in tumor control, hearing preservation, or complications were found in comparing the results of GKRS for NF2-related VS versus GKRS for sporadic VS.CONCLUSIONSWith modern GKRS, the use of low margin doses for treating growing VSs in patients with NF2 demonstrates good long-term tumor control rates. Feiling-Gardner phenotype and tumor volume smaller than 6 cm3 seem to be independently associated with prolonged progression-free survival, highlighting the clinical importance of phenotype assessment before GKRS treatment. In addition, no significant differences in tumor control rates or complications were found in the matched-control cohort analysis comparing GKRS for VS in patients with NF2 and GKRS for sporadic VS. These results show that GKRS is a valid treatment option for NF2-related VS, in addition to being a good option for sporadic VS, particularly in patients with the Feiling-Gardner phenotype and/or tumors that are small to medium in size. Larger tumors in patients with the Wishart phenotype appear to respond poorly to radiosurgery, and other treatment modalities should therefore be considered in such cases.

scholarly journals Gamma knife radiosurgery for vestibular schwannomas: Results of hearing preservation in relation to the cochlear radiation dose

2009 ◽  
Vol 119 (6) ◽  
pp. 1076-1081 ◽  
Author(s):  
Ferdinand C. A. Timmer ◽  
Patrick E. J. Hanssens ◽  
Anniek E. P. van Haren ◽  
Jef J. S. Mulder ◽  
Cor W. R. J. Cremers ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Hearing Preservation ◽  
Vestibular Schwannomas

Bevacizumab treatment for vestibular schwannomas in neurofibromatosis type two: report of two cases, including responses after prior gamma knife and vascular endothelial growth factor inhibition therapy

2011 ◽  
Vol 126 (1) ◽  
pp. 79-82 ◽  
Author(s):  
G K Eminowicz ◽  
R Raman ◽  
J Conibear ◽  
P N Plowman
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Gamma Knife ◽  
Previous History ◽  
Gamma Knife Radiosurgery ◽  
Neurofibromatosis Type ◽  
Vestibular Schwannomas ◽  
Vascular Endothelial ◽  
Bevacizumab Treatment ◽  
Endothelial Growth Factor

AbstractObjectives:Vestibular schwannomas are the hallmark of neurofibromatosis type two. They are difficult to treat, due to their bilateral presentation and the quest for hearing preservation. Our report describes a new treatment approach in this clinical scenario.Case report:We report two cases which confirm that bevacizumab, a monoclonal antibody targeting vascular endothelial growth factor, causes regression of vestibular schwannomas in patients with a previous history of gamma knife radiosurgery or failed treatment with another form of vascular endothelial growth factor targeted therapy.Conclusion:In 2009, Plotkin et al. reported the volumetric response of vestibular schwannomas to bevacizumab treatment, both in untreated patients and in patients previously treated with erlotinib, an epidermal growth factor receptor inhibitor. The presented cases support the use of bevacizumab to treat vestibular schwannomas. Given the extremely slow growth of these tumours, we note the rapidity of volume reduction following bevacizumab therapy.

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