Information on outcomes of Gamma Knife surgery (GKS) for patients harboring trigeminal schwannomas is limited because these tumors are rare. The authors evaluated tumor control and functional outcomes in patients who underwent GKS for trigeminal schwannomas to clarify the efficacy of this treatment.
Forty-two patients with trigeminal schwannomas but no evidence of neurofibromatosis Type 2 were treated with GKS at Komaki City Hospital between November 1991 and December 2003. Of these, 37 patients were assessed. The mean tumor volume in these patients was 10 cm3.平均最大radiation dose directed to the tumor was 27.9 Gy and the mean dose directed to the tumor margin was 14.2 Gy. The mean follow-up period was 54 months. In four patients (11%) there was complete tumor remission; in 20 (54%) there was partial tumor remission; in eight (22%) the disease remained stable; and in five (14%) the tumor enlarged or uncontrollable facial pain developed with radiation-induced edema requiring resection. The actuarial 5- and 10-year tumor control rates were both 84%. With respect to functional outcomes, 40% of patients noted an improvement in their symptoms, and one patient experienced new symptoms despite good tumor control.
Gamma Knife surgery was a safe and effective treatment for a select group of patients harboring trigeminal schwannomas. Large tumors that compress the brainstem and cause deviation of the fourth ventricle should first be removed surgically and any remnant should be treated by GKS.
Al-MeftyO,,AyoubiS,&GaberE:Trigeminal schwannomas: removal of dumbbell-shaped tumors through the expanded Meckel cave and outcomes of cranial nerve function.J Neurosurg96:453- - - - - -463,2002
ArseniC,,DumitrescuL,&ConstantinescuA:Neurinomas of the trigeminal nerve.Surg Neurol4:497- - - - - -503,1975
DayJD,&FukushimaT:The surgical management of trigeminal neuromas.开云体育app官方网站下载入口42:233- - - - - -241,1998
EisenbergMB,,Al-MeftyO,,DeMonteF,&BursonGT:Benign non-meningeal tumors of the cavernous sinus.开云体育app官方网站下载入口44:949- - - - - -955,1999
GoelA,,MuzumdarD,&内存anC:Trigeminal neuroma: analysis of surgical experience with 73 cases.开云体育app官方网站下载入口52:783- - - - - -790,2003
HasegawaT,,FujitaniS,,KatsumataS,,KidaY,,YoshimotoM,&KoikeJ:Stereotactic radiosurgery for vestibular schwannomas: analysis of 317 patients followed more than 5 years.开云体育app官方网站下载入口57:257- - - - - -265,2005
HasegawaT,,KidaY,,KobayashiT,,YoshimotoM,,MoriY,&YoshidaJ:Long-term outcomes in patients with vestibular schwannomas treated using gamma knife surgery: 10-year follow-up.J Neurosurg102:10- - - - - -16,2005
IwaiY,,YamanakaK,&YoshimuraM:Gamma knife radiosurgery for cavernous sinus metastases and invasion.Surg Neurol64:406- - - - - -410,2005
JeffersonG:The trigeminal neurinomas with some remarks on malignant invasion of the gasserian ganglion.Clin Neurosurg1:11- - - - - -54,1953
KidaY,,KobayashiT,&MoriM:Radiosurgery of cavernous hemangiomas in the cavernous sinus.Surg Neurol56:117- - - - - -123,2001
KidaY,,KobayashiT,&TanakaT,Radiosurgery of trigeminal neurinoma.inAlexanderEIII,,KondziolkaD,,LindquistC,&LoefflerJS:(eds)Radiosurgery, Vol 2New York,Karger,1997.pp8- - - - - -15
KondziolkaD,,LunsfordLD,,McLaughlinMR,&FlickingerJC:Long-term outcomes after radiosurgery for acoustic neuromas.N Engl J Med339:1426- - - - - -1433,1998
KondziolkaD,,NathooN,,FlickingerJC,,NiranjanA,,MaitzAH,&LunsfordLD:Long-term results after radiosurgery for benign intracranial tumors.开云体育app官方网站下载入口53:815- - - - - -822,2003
KonovalovAN,,SpalloneA,,MukhamedjanovDJ,,TcherekajevVA,&MakhmudovUB:Trigeminal neurinomas. A series of 111 surgical cases from a single institution.Acta Neurochir (Wien)138:1027- - - - - -1035,1996
KuoJS,,ChenJCT,,YuC,,ZelmanV,,GiannottaSL,&PetrovichZ,et al.:Gamma knife radiosurgery for benign cavernous sinus tumors: quantitative analysis of treatment outcomes.开云体育app官方网站下载入口54:1385- - - - - -1394,2004
LeeJY,,NiranjanA,,McInerneyJ,,KondziolkaD,,FlickingerJC,&LunsfordLD:Stereotactic radiosurgery providing long-term tumor control of cavernous sinus meningiomas.J Neurosurg97:65- - - - - -72,2002
MabantaSR,,BuattiJM,,FriedmanWA,,MeeksSL,,MendenhallWM,&BovaFJ:Linear accelerator radiosurgery for nonacoustic schwannomas.Int J Radiat Oncol Biol Phys43:545- - - - - -548,1999
MaruyamaK,,ShinM,,KuritaH,,KawaharaN,,MoritaA,&KirinoT:Proposed treatment strategy for cavernous sinus meningiomas: a prospective study.开云体育app官方网站下载入口55:1068- - - - - -1075,2004
McCormickPC,,BelloJA,&PostKD:Trigeminal schwannoma. Surgical series of 14 cases with review of the literature.J Neurosurg69:850- - - - - -860,1988
MetellusP,,RejisJ,,MuraccioleX,,FuentesS,,DufourH,&NanniI,et al.:Evaluation of fractionated radiotherapy and gamma knife radiosurgery in cavernous sinus meningiomas: treatment strategy.开云体育app官方网站下载入口57:873- - - - - -886,2005
NettelB,,NiranjanA,,MartinJJ,,KoebbeCJ,,KondziolkaD,&FlickingerJC,et al.:Gamma knife radiosurgery for trigeminal schwannomas.Surg Neurol62:435- - - - - -446,2004
PanL,,WangEM,,ZhangN,,ZhouLF,,WangBJ,&DongYF,et al.:Long-term results of Leksell gamma knife surgery for trigeminal schwannomas.J Neurosurg102:Suppl220- - - - - -224,2005
PekerS,,KilicT,,SengozM,&PamirMN:Radiosurgical treatment of cavernous sinus cavernous haemangiomas.Acta Neurochir (Wien)146:337- - - - - -341,2004
PollackIF,,SekherLN,,JannettaPJ,&JaneckaIP:Neurilemomas of the trigeminal nerve.J Neurosurg70:737- - - - - -745,1989
PollockBE,,FooteRL,&StaffordSL:Stereotactic radiosurgery: the preferred management for patients with nonvestibular schwannomas?.Int J Radiat Oncol Biol Phys52:1002- - - - - -1007,2002
PollockBE,,KondziolkaD,,FlickingerJC,,MaizA,&LunsfordLD:Preservation of cranial nerve function after radiosurgery for non-acoustic schwannomas.开云体育app官方网站下载入口33:597- - - - - -601,1993
PollockBE,&StaffordSL:Results of stereotactic radiosurgery for patients with imaging defined cavernous sinus meningiomas.Int Radiat Oncol Biol Phys62:1427- - - - - -1431,2005
SamiiM,,MiglioriMM,,TatagibaM,&BabuR:Surgical treatment of trigeminal schwannomas.J Neurosurg82:711- - - - - -718,1995
SchisanoG,&OlivecronaH:Neurinomas of the Gasserian ganglion and trigeminal root.J Neurosurg17:306- - - - - -322,1960
TahaJM,,努力工作JMJr,,Van LoverenHR,,KellerJT,&el-KallinyM:Comparison of conventional and skull base surgical approaches for the excision of trigeminal neurinomas.J Neurosurg82:719- - - - - -725,1995
ThompsonTP,,LunsfordLD,&FlickingerJC:Radiosurgery for hemangioblastoma of the cavernous sinus and orbit: technical case report.开云体育app官方网站下载入口47:778- - - - - -783,2000
WallnerKE,,PittsLH,,DavisRL,&ShelineGE:Radiation therapy for the treatment of non-eight nerve intracranial neurilemmoma.Int J Radiat Oncol Biol Phys14:287- - - - - -290,1988
YamasakiT,,NagaoS,,KagawaT,,TakamuraM,,MoritakeK,&TanakaY,et al.:[Therapeutic effectiveness of combined microsurgery and radiosurgery in a patient with a huge trigeminal neurinoma.].No To Shinkei48:845- - - - - -850,1996.(Jpn)
YasuiT,,HakubaA,,KimSH,&NishimuraS:Trigeminal neurinomas: operative approach in eight cases.J Neurosurg71:506- - - - - -511,1989
YoshidaK,&KawaseT:Trigeminal neurinomas extending into multiple fossae: surgical methods and review of the literature.J Neurosurg91:202- - - - - -211,1999
ZabelA,,DebusJ,,ThilmannC,,SchlegelW,&WannenmacherM:Management of benign cranial nonacoustic schwannomas by fractionated stereotactic radiotherapy.Int J Cancer96:356- - - - - -362,2001
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