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Trigeminal schwannomas: results of Gamma Knife surgery in 37 cases

Toshinori Hasegawa Department of Neurosurgery, Gamma Knife Center, Komaki City Hospital, Komaki, Japan

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Yoshihisa Kida Department of Neurosurgery, Gamma Knife Center, Komaki City Hospital, Komaki, Japan

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Masayuki Yoshimoto Department of Neurosurgery, Gamma Knife Center, Komaki City Hospital, Komaki, Japan

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Jouji Koike Department of Neurosurgery, Gamma Knife Center, Komaki City Hospital, Komaki, Japan

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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.

开云体育世界杯赔率

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.

Conclusions

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.

Abbreviations used in this paper:

GKS = Gamma Knife surgery ; MR = magnetic resonance ; SRS = stereotactic radiosurgery
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