Successful CyberKnife Irradiation of 1000 cc Hemicranial XXXX : 6-year Follow-up.

@entity1 @entity7841 @entity154 @entity1183 @entity4916 @entity428 @entity5 @entity10413 @entity735 @entity1653 @entity10
@entity1653 are common @entity5 with accepted treatment approaches and usually don't challenge healthcare specialists. We present a case of a huge unresectable @entity10413 , which was successfully treated with hypofractionated @entity7841 . A male @entity1 , sixty-two years of age, suffered for over 12 years from @entity10 , @entity154 , @entity735 , right eye movement restriction, right-sided ptosis, and @entity1183 . MRI and CT studies revealed an extended @entity10413 . Prior to @entity7841 , the @entity1 underwent four operations. Eventually, the @entity5 was irradiated with the CyberKnife in August 2009. @entity5 volume composed 1085 cc. The mean dose of 35.3 Gy was delivered in 7 fractions (31.5 Gy at 72% isodose line comprising 95% of @entity5 volume). The @entity1 was followed during six years and experienced only mild (Grade 1-2 CTCAE) acute skin  and mucosa reactions. During the follow-up period, we observed target volume shrinkage for 17% (for 26% after excluding @entity4916 ) and regression of @entity428 signs. Due to the extreme volume and complex shape of the @entity5 , spreading along the surface of the hemisphere as well as an optic nerve involvement, the case presented would not be generally  considered suitable for @entity7841 , especially for hypofractionation. We regard this clinical situation not as a treatment recommendation, but as a demonstration of the underestimated possibilities of hypofractionation regimen and CyberKnife system, both of which are limited with our habit of conventional treatments.
