Long-term results of gamma knife surgery for the treatment of craniopharyngioma in 98 consecutive cases
Tatsuya Kobayashi
Tatsuya Kobayashi
Nagoya Radiosurgery Center, Nagoya Kyoritsu Hospital; and Department of Neurosurgery, Gamma Knife Center, Komaki City Hospital, Nagoya, Japan
Yoshihisa Kida
Nagoya Radiosurgery Center, Nagoya Kyoritsu Hospital; and Department of Neurosurgery, Gamma Knife Center, Komaki City Hospital, Nagoya, Japan
Yoshimasa Mori
Nagoya Radiosurgery Center, Nagoya Kyoritsu Hospital; and Department of Neurosurgery, Gamma Knife Center, Komaki City Hospital, Nagoya, Japan
Toshinori Hasegawa
Nagoya Radiosurgery Center, Nagoya Kyoritsu Hospital; and Department of Neurosurgery, Gamma Knife Center, Komaki City Hospital, Nagoya, Japan
The authors analyzed the long-term outcomes of gamma knife surgery (GKS) for residual or recurrent craniopharyngiomas after microsurgery and the effects of dose reduction.
开云体育世界杯赔率
A total of 107 patients with craniopharyngiomas were treated with GKS at Komaki City Hospital during the past 12 years, and 98 patients were followed up for 6 to 148 months (mean 65.5 months). The mean tumor diameter and volume were 18.8 mm and 3.5 ml, respectively. These tumors were treated with a maximal dose of 21.8 Gy and a tumor margin dose of 11.5 Gy by using a mean of 4.5 isocenters. Final overall response rates were as follows: complete response 19.4%, partial response 67.4%, tumor control 79.6%, and tumor progression 20.4%. Reducing the tumor margin dose resulted in decreased therapeutic response and increased tumor progression, although the rate of visual and pituitary function loss also decreased. Among the factors examined, age (for adults) and the nature of the tumor (cystic or mixed) were statistically significant favorable and unfavorable prognostic factors, respectively. The actuarial 5- and 10-year survival rates were 94.1 and 91%, respectively. The progression-free survival rates were 60.8 and 53.8%, respectively. Patient outcomes were reportedly excellent in 45 cases, good in 23, fair in four, and poor in three; 16 patients died. Deterioration both in vision and endocrinological functions were documented as side effects in six patients (6.1%).
Conclusions
立体定向门将是安全有效的,朗g term, as an adjuvant or boost therapy for residual or recurrent craniopharyngiomas after surgical removal and has minimal side effects. New treatment strategies must be devised to manage these tumors.
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