Gamma Knife surgery for XXXX : long-term results including complications, predictive factors, and progression-free survival.

@entity1 @entity129 @entity5 @entity51 @entity1653
OBJECT: Stereotactic radiosurgery serves as an important primary and adjuvant treatment option for @entity1 with many types of @entity1653 . This is particularly true for @entity1 with @entity1653 . In this study, the authors evaluated the outcomes of Gamma Knife surgery (GKS) used to treat @entity1653 . METHODS: The study is a retrospective review of the outcomes in 138 @entity1 with @entity1653 treated at the University of Virginia from 1989 to 2006; all @entity1 had a minimum follow-up of 24 months. There were 31 @entity1 and 107 @entity1 whose mean age was 54 years (range 19-85 years). Eighty-four @entity1 had previously undergone resection. The mean pre-GKS @entity5 volume was 7.5 ml (range 0.2-54.8 ml). Clinical and radiographic evaluations were performed, and factors related to favorable outcomes in each case were assessed. RESULTS: The mean follow-up duration was 84 months (median 75.5 months, range 24-216 months). In 118 @entity1 (86%), the @entity5 volume was unchanged or had decreased at last follow-up. Kaplan-Meier analysis demonstrated radiographic progression-free survival at 5 and 10 years to be 95.4% and 69%, respectively. Fourteen @entity1 (10%) developed new @entity129 following GKS. Factors associated with @entity5 control included younger age, a higher isodose, and smaller @entity5 volume. A longer follow-up duration was associated with either a decrease or increase in @entity5 volume. Fourteen @entity1 (10%) experienced new or worsening @entity129 after treatment. Factors associated with this occurrence were larger pretreatment @entity5 volume, lower peripheral radiation dose, lower maximum dose, @entity5 progression, and longer follow-up. CONCLUSIONS: Gamma Knife surgery offers an acceptable rate of @entity5 control for @entity1653 and accomplishes this with a low incidence of @entity51 . Radiological control after radiosurgery is more likely in those @entity1 with a smaller @entity5 volume and a higher prescription dose.
