Yun-Sik Dho1, Yong Hwy Kim1, Jin Wook Kim1, Chul-Kee Park1, Hyun-Tai Chung1, Seung-Ki Kim1,2, Sun Ha Paek1, Kyu-Chang Wang1,2, Dong Gyu Kim3. 1. Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul, 03080, Republic of Korea. 2. Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul, Republic of Korea. 3. Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul, 03080, Republic of Korea. gknife@snu.ac.kr.
Abstract
OBJECT: To analyze the outcomes of gamma knife radiosurgery (GKS) for craniopharyngiomas and elucidate the optimal strategy. METHODS: Between 1998 and 2016, 35 patients underwent GKS for the treatment of 40 recurrent or residual craniopharyngiomas. Among 40 GKSs, 22 procedures were single-session GKSs and 18 procedures were fractionated GKSs. In cases of single-session GKS, the median marginal dose was 15 Gy (range 10-20 Gy). In cases of fractionated GKS, the median marginal dose was 6 Gy (range 5-7.5 Gy) of three fractions. The radiation dose was calculated to the biologic equivalent dose (BED) using α/β ratios of 10 and 2. RESULT: The location of the tumor, the distance between the optic nerve and tumor (> 10 mm), BED 10 (> 35 Gy), and BED2 (> 80 Gy) were statistically significant with overall response rate (P = 0.008, 0.02, 0.03, and 0.002, respectively). There was a statistically significant difference in progression-free survival according to the distance between the optic nerve and tumor (> 10 mm) and the location of tumor (P = 0.03 and 0.03, respectively). Multivariate logistic regression analysis showed the hypothalamus group had an odds ratio of 0.04 compared with the suprasellar group for tumor progression. The group with BED2 > 80 Gy had an odds ratio of 0.049 compared with the group with BED2 < 80 Gy. CONCLUSION: A sufficient dose is required for treating craniopharyngiomas using single-session and fractionated GKS. The outcomes of GKS can be predicted according to the location of tumor, the distance between the optic nerve and tumor and BED value.
OBJECT: To analyze the outcomes of gamma knife radiosurgery (GKS) for craniopharyngiomas and elucidate the optimal strategy. METHODS: Between 1998 and 2016, 35 patients underwent GKS for the treatment of 40 recurrent or residual craniopharyngiomas. Among 40 GKSs, 22 procedures were single-session GKSs and 18 procedures were fractionated GKSs. In cases of single-session GKS, the median marginal dose was 15 Gy (range 10-20 Gy). In cases of fractionated GKS, the median marginal dose was 6 Gy (range 5-7.5 Gy) of three fractions. The radiation dose was calculated to the biologic equivalent dose (BED) using α/β ratios of 10 and 2. RESULT: The location of the tumor, the distance between the optic nerve and tumor (> 10 mm), BED 10 (> 35 Gy), and BED2 (> 80 Gy) were statistically significant with overall response rate (P = 0.008, 0.02, 0.03, and 0.002, respectively). There was a statistically significant difference in progression-free survival according to the distance between the optic nerve and tumor (> 10 mm) and the location of tumor (P = 0.03 and 0.03, respectively). Multivariate logistic regression analysis showed the hypothalamus group had an odds ratio of 0.04 compared with the suprasellar group for tumor progression. The group with BED2 > 80 Gy had an odds ratio of 0.049 compared with the group with BED2 < 80 Gy. CONCLUSION: A sufficient dose is required for treating craniopharyngiomas using single-session and fractionated GKS. The outcomes of GKS can be predicted according to the location of tumor, the distance between the optic nerve and tumor and BED value.
Authors: Ajay Niranjan; Hideyuki Kano; David Mathieu; Douglas Kondziolka; John C Flickinger; L Dade Lunsford Journal: Int J Radiat Oncol Biol Phys Date: 2009-12-16 Impact factor: 7.038
Authors: Diana C H Stripp; Amit Maity; Anna J Janss; Jean B Belasco; Zelig A Tochner; Joel W Goldwein; Thomas Moshang; Lucy B Rorke; Peter C Phillips; Leslie N Sutton; Hui-Kuo G Shu Journal: Int J Radiat Oncol Biol Phys Date: 2004-03-01 Impact factor: 7.038