Preservation of visual fields after peri-sellar gamma-knife radiosurgery.
Radiosurgical treatment of pituitary and peri-sellar tumors has become an increasingly utilized modality as an alternative to conventional radiotherapy and surgery. Such radiosurgery results in a relatively high dose of radiation to the optic chiasm. The clinical data establishing safe single-fraction doses to the chiasm is immature, although taken together previous literature suggests a recommended maximal dose of 8 Gy. Optic neuropathy, when it occurs, tends to take place within 2 years of treatment. We evaluated the visual fields of 20 sequential patients that received significant doses to the optic chiasm by Gamma-knife radiosurgery. There were 17 cases of pituitary adenoma and 3 cases of meningioma, and two patients refused follow-up testing. Preoperative visual field and cranial nerve examinations were done prior to radiosurgery and in follow-up, with a median follow-up of 24 months. There were no cases of quantitative visual field deficit induced by treatment. No patients developed symptomatic visual deterioration. Radiat. Oncol. Invest. 90:343-350, 2000. 2000 Wiley-Liss, Inc.
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Department of Radiation Oncology, University of Maryland Medical System, 22 S. Greene St., Baltimore, Maryland 21201, USA. ove@uabmc.edu
Kelman
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D000236:Adenoma / Q000401:mortality / Q000601:surgery*; D006801:Humans; D009897:Optic Chiasm / Q000528:radiation effects*; D009900:Optic Nerve / Q000528:radiation effects; D010911:Pituitary Neoplasms / Q000401:mortality / Q000601:surgery*; D016634:Radiosurgery / Q000009:adverse effects*; D012658:Sella Turcica; D014794:Visual Fields / Q000528:radiation effects*