PURPOSE: To determine whether the 12-Gy radiosurgical volume (12-GyV) correlates with the development of postradiosurgical imaging changes suggestive of radiation necrosis in patients treated for non-arteriovenous malformation (non-AVM) intracranial tumors with gamma knife stereotactic radiosurgery (GKSRS). METHODS AND MATERIALS: A retrospective single-institution review of 129 patients with 198 separate non-AVM tumors was performed. Patients were followed with magnetic resonance imaging (MRI) and physical examinations at 3- to 6-month intervals. Patients who developed postradiosurgical MRI changes suggestive of radiation necrosis were labeled as having either symptomatic radiation necrosis (S-NEC) if they experienced any decline in neurologic examination associated with the imaging changes, or asymptomatic radiation necrosis (A-NEC) if they had a stable or improving neurologic examination. RESULTS: 12-GyV correlated with risk of S-NEC, which was 23% (for 12-GyV of 0-5 cc), 20% (5-10 cc), 54% (10-15 cc), and 57% (>15 cc). The risk of A-NEC did not significantly change with 12-GyV. Logistic regression analyses showed that the following factors were associated with the development of S-NEC: 12-GyV (p<0.01), occipital and temporal lesions (p<0.01), previous whole-brain radiotherapy (p=0.03), and male sex (p=0.03). Radiosurgical plan conformality did not correlate with the development of S-NEC. CONCLUSION: The risk of S-NEC, but not A-NEC after GKSRS for non-AVM tumors correlates with 12-GyV, and increases significantly for 12-GyV>0 cc.
PURPOSE: To determine whether the 12-Gy radiosurgical volume (12-GyV) correlates with the development of postradiosurgical imaging changes suggestive of radiation necrosis in patients treated for non-arteriovenous malformation (non-AVM) intracranial tumors with gamma knife stereotactic radiosurgery (GKSRS). METHODS AND MATERIALS: A retrospective single-institution review of 129 patients with 198 separate non-AVM tumors was performed. Patients were followed with magnetic resonance imaging (MRI) and physical examinations at 3- to 6-month intervals. Patients who developed postradiosurgical MRI changes suggestive of radiation necrosis were labeled as having either symptomatic radiation necrosis (S-NEC) if they experienced any decline in neurologic examination associated with the imaging changes, or asymptomatic radiation necrosis (A-NEC) if they had a stable or improving neurologic examination. RESULTS:12-GyV correlated with risk of S-NEC, which was 23% (for 12-GyV of 0-5 cc), 20% (5-10 cc), 54% (10-15 cc), and 57% (>15 cc). The risk of A-NEC did not significantly change with 12-GyV. Logistic regression analyses showed that the following factors were associated with the development of S-NEC: 12-GyV (p<0.01), occipital and temporal lesions (p<0.01), previous whole-brain radiotherapy (p=0.03), and male sex (p=0.03). Radiosurgical plan conformality did not correlate with the development of S-NEC. CONCLUSION: The risk of S-NEC, but not A-NEC after GKSRS for non-AVM tumors correlates with 12-GyV, and increases significantly for 12-GyV>0 cc.
Authors: R Wiggenraad; A Verbeek-de Kanter; M Mast; R Molenaar; H B Kal; G Lycklama à Nijeholt; C Vecht; H Struikmans Journal: Strahlenther Onkol Date: 2012-06-23 Impact factor: 3.621
Authors: Yaacov Richard Lawrence; X Allen Li; Issam el Naqa; Carol A Hahn; Lawrence B Marks; Thomas E Merchant; Adam P Dicker Journal: Int J Radiat Oncol Biol Phys Date: 2010-03-01 Impact factor: 7.038
Authors: E Liniker; A M Menzies; B Y Kong; A Cooper; S Ramanujam; S Lo; R F Kefford; G B Fogarty; A Guminski; T W Wang; M S Carlino; A Hong; G V Long Journal: Oncoimmunology Date: 2016-08-19 Impact factor: 8.110
Authors: Perry B Johnson; Maria I Monterroso; Fei Yang; Elizabeth Bossart; Amir Keyvanloo; Eric A Mellon Journal: World Neurosurg Date: 2018-11-24 Impact factor: 2.104