Gamma knife radiosurgery for XXXX : early results.

@entity1 @entity129 @entity137 @entity2013 @entity66 @entity5 @entity977 @entity652
OBJECTIVE: In recent years, gamma knife radiosurgery (GKRS) has emerged as an important treatment modality in the management of @entity977 . Treatment results after performing GKRS and the complications of this procedure are reviewed. METHODS: Between 1994 and 2002, a total of 78 @entity1 with @entity977 underwent a total of 84 GKRS procedures in our medical center. This @entity1 group comprised 46 @entity1 (59%) and 32 @entity1 (41%). All @entity1 were treated for recurrent or @entity66 after surgery or radiotherapy, with 83% presenting with extensive @entity5 involvement. The cavernous sinus was involved in 75 @entity1 (96%), and 22 @entity1 (28%) had hormone-secreting @entity652 . This latter subset of @entity1 included 12 @entity2013 (15%), 6 growth-hormone secreting @entity5 (8%), and 4 adrenocorticotropic hormone-secreting @entity5 (5%). The median @entity5 volume was 2.3 cm(3), and the median radiation dose was 15 Gy defined to the 50% isodose line. The mean and median follow-up periods were 41 and 36 months, respectively. RESULTS: GKRS was tolerated well in these @entity1 ; acute @entity137 was uncommon and of no clinical significance. Late @entity137 was noted in three @entity1 (4%) and consisted of VIth @entity129 . In two @entity1 , there was spontaneous resolution of this palsy, and in one @entity1 , it persisted for the entire 3-year duration of follow-up. Of the 15 @entity1 who presented with @entity129 , 8 (53%) experienced complete recovery and 3 (20%) showed major improvement within 12 months of therapy. @entity5 volume reduction was slow, with 30% of @entity1 showing decreased @entity5 volume more than 3 years after undergoing GKRS. None of the 56 @entity1 with nonfunctioning @entity5 showed progression in the treated volume, and 4 (18%) of the 22 hormone-secreting @entity5 relapsed (P = 0.008). Of the four @entity1 with adrenocorticotropic hormone-secreting @entity652 , therapy failed in two of them. All six @entity1 with growth hormone-producing @entity5 responded well to therapy. Of the 12 @entity1 with @entity2013 10 (83%) had normalization of hormone level and 2 @entity1 experienced increasing prolactin level. Two @entity1 with @entity2013 had three normal pregnancies after undergoing GKRS. CONCLUSION: GKRS is a safe and effective therapy in selected @entity1 with @entity977 . None of the @entity1 in our study experienced injury to the optic apparatus. A radiation dose higher than 15 Gy is probably needed to improve control of hormone-secreting @entity652 . Longer follow-up is required for a more complete assessment of late @entity137 and treatment efficacy.
