title: Single-session Gamma Knife radiosurgery for optic pathway/hypothalamic gliomas.
abstract: OBJECTIVE Because of their critical and central location, it is deemed necessary to fractionate when considering irradiating optic pathway/hypothalamic gliomas. Stereotactic fractionated radiotherapy is considered safer when dealing with gliomas in this location. In this study, the safety and efficacy of single-session stereotactic radiosurgery for optic pathway/hypothalamic gliomas were reviewed. METHODS Between December 2004 and June 2014, 22 patients with optic pathway/hypothalamic gliomas were treated by single-session Gamma Knife radiosurgery. Twenty patients were available for follow-up for a minimum of 1 year after treatment. The patients were 5 to 43 years (median 16 years) of age. The tumor volume was 0.15 to 18.2 cm3(median 3.1 cm3). The prescription dose ranged from 8 to 14 Gy (median 11.5 Gy). RESULTS The mean follow-up period was 43 months. Five tumors involved the optic nerve only, and 15 tumors involved the chiasm/hypothalamus. Two patients died during the follow-up period. The tumors shrank in 12 cases, remained stable in 6 cases, and progressed in 2 cases, thereby making the tumor control rate 90%. Vision remained stable in 12 cases, improved in 6 cases, and worsened in 2 cases in which there was tumor progression. Progression-free survival was 83% at 3 years. CONCLUSIONS The initial results indicate that single-session Gamma Knife radiosurgery is a safe and effective treatment option for optic pathway/hypothalamic gliomas.
authors.affiliation: Gamma Knife Center Cairo.|Neurosurgery Department and.
authors.forename: Amr M N
authors.initials: AM
authors.lastname: El-Shehaby
authors.affiliation: Gamma Knife Center Cairo.|Neurosurgery Department and.
authors.forename: Wael A
authors.initials: WA
authors.lastname: Reda
authors.affiliation: Gamma Knife Center Cairo.|Clinical Oncology Department, Faculty of Medicine, Ain Shams University.
authors.forename: Khaled M
authors.initials: KM
authors.lastname: Abdel Karim
authors.affiliation: Gamma Knife Center Cairo.|Radiation Oncology Department, National Cancer Institute, Cairo University, Cairo; and.
authors.forename: Reem M
authors.initials: RM
authors.lastname: Emad Eldin
authors.affiliation: Gamma Knife Center Cairo.|Neurosurgery Department, Faculty of Medicine, Benha University, Qalubya, Egypt.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Nabeel
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005910:Glioma / Q000532:radiotherapy*; D006801:Humans; D007029:Hypothalamic Neoplasms / Q000532:radiotherapy*; D008297:Male; D009897:Optic Chiasm; D019574:Optic Nerve Neoplasms / Q000532:radiotherapy*; D065866:Optic Tract; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: EBRT = external-beam radiotherapy; Gamma Knife; MRS = MR spectroscopy; fractionation; glioma; hypothalamic; optic; single session; stereotactic radiosurgery